CT Findings in Diffuse Rectosigmoid Cavernous Heamangioma. A Case Report

Abstract

A 15-year-old boy presented with long-standing bleeding of the rectum to the department of gastroenterology. Per rectal digital examination and proctoscopy did not reveal any definite local cause of bleeding. The patient was sent to the department of radiology for computed tomography (CT) scan. CT was done on 64 multislice CT scan, which shows marked rectosigmoid wall thickening as a result of varices and vascular malformations and phleboliths of the rectosigmoid colon. The patient was subjected to abdominal surgery in which a sphincter-saving procedure was done. Postoperative course in the hospital was uneventful.

Three‐dimensional laparoscopy‐assisted bowel resection for cavernous hemangioma of the rectum: Report of two cases

“…However, MRI is superior to CT because it provides a sufficient level of detail to accurately recognize the extent of the lesion and resection (5). Since then, about 100 cases of DCHR have been reported.…”

Diffuse cavernous hemangioma of the rectum (DCHR) – diagnosis and treatment – case report and review of available literature

“…First line diagnostic method in suspected DCHR is colonoscopy, allowing for assessment of morphology of the lesion, its location and extent of the infiltration (1, 5, 7). Specimen collection from suspected DCHR lesions is not recommended due to high risk of bleeding (1,3,4,11). MRI is a complementary procedure to colonoscopy.…”

“…MRI is a complementary procedure to colonoscopy. It provides sufficient amount of details that are required to plan the extent of a surgical procedure, enables formation of a multiplane image of a mass as well as imaging without the contrast administration in patients allergic to it (3,7,9). CT imaging is characterized by lower sensitivity in diagnosing DCHR, although allows for visualization of calcifications (phleboliths) characteristic for DCHR as well as assessment of extent of the infiltration (2,3,7,9).…”

“…It provides sufficient amount of details that are required to plan the extent of a surgical procedure, enables formation of a multiplane image of a mass as well as imaging without the contrast administration in patients allergic to it (3,7,9). CT imaging is characterized by lower sensitivity in diagnosing DCHR, although allows for visualization of calcifications (phleboliths) characteristic for DCHR as well as assessment of extent of the infiltration (2,3,7,9). The other diagnostic procedures (angiography, abdominal ultrasound, plain abdominal X-ray, digital rectal examination) are characterized by low sensitivity and specificity and therefore are not recommended as part of the diagnostic algorithm of DCHR (1,2,5,6,7,9).…”

“…Until 1970 abdominoperoneal rectal resection was the treatment of choice, however due to colostomy unacceptable in this age group and sexual and urological disorders, there has been a tendency to perform this type of procedure only in patients with adverse disease location or infiltration of the perineum, gluteal region or anal canal (1,3,10). Attempts of "endorectal pull-through" procedure were reported, although their long term results were unsatisfactory (9).…”