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2012, Number 1

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Cir Gen 2012; 34 (1)

Cavernous hemangioma of the rectosigmoid, a rare and poorly studied disease

O’Farril AR, Herrejón CJM, Coyoli GÓ, Martínez CJM, Toledo CCR, Jiménez GA

Language: Spanish
References: 42
Page: 65-71
PDF size: 100.14 Kb.


ABSTRACT

Objective: To describe the most relevant data of cavernous hemangioma of the rectosigmoid, including diagnostic bases and treatment variety.
Setting: Third Level Health Care Hospital.
Design: Bibliography review.
Material and methods: A search was performed in the Medigraphic, Cochrane, Medline and PubMed databases, including the review of original articles and treatment guidelines. Key words used for the search were: Rectum, transanal bleeding, cavernous hemangioma, phleboliths.
Results: The cavernous hemangioma affects more frequently the rectosigmoid, the main symptom is fresh transanal bleeding in up to 90% of cases. Therefore, a careful clinical history must be included for diagnosis, as well as a complete proctologic exploration.
Rectosigmoidoscopy or colonoscopy is a useful study because it reveal the status of the mucosa, but because this is a vascular originated pathology, a biopsy is not indicated owing to the risk of bleeding. Imaging studies to complement the diagnosis must be performed pre-operatively since they delimit accurately the injury, these include abdominal X rays, CAT, MRI, angiography, 360° endoanal and endorectal ultrasonography. The treatment of choice until this moment is complete surgical resection, in its different modalities according to the level of affection.
Conclusions: The cavernous hemangioma is a vascular injury that manifests clinically as fresh transanal bleeding. We must consider this entity as differential diagnosis from more common diseases at the anorectal level when having a negative anoscopy and avoid subjecting the patient to a wrong surgery because of misdiagnosis.


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