>Year 2011, Issue 3
O’Farril AR, Herrejón CJM, Coyoli GÓ, Martínez CJM, Toledo CCR, Jiménez GA
Cavernous hemangioma in the rectosigmoid, an uncommon pathology wrongly studied
Cir Gen 2011; 33 (3)
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Objective: To describe the most relevant data of the cavernous hemangioma of the rectosigmoid, including the bases for diagnosis and variety of treatment.
Design: Review of the corresponding literature.
Material and methods: A search in Medigraphic, Cochrane, Medline, and PubMed databases was performed, including for the review research articles and treatment guidelines. Assessed variables were: main symptom, diagnostic studies, and treatment of choice.
Results: The cavernous hemangioma affects most frequently the rectosigmoid, the main symptom is fresh transanal bleeding in up to 90% of cases, therefore, a careful and detailed clinical history must be included as well as a complete proctologic exploration. Rectosigmoidoscopy or colonoscopy is very useful by revealing the mucosal aspect, but since it is a disease of vascular origin, a biopsy is contraindicated due to the risk of bleeding. Imaging studies as diagnostic complementation must be performed pre-operatively, since they delimit precisely the injury; these studies include abdominal Rx, CAT, MRI, angiography, and 360° endorectal and endonal ultrasonography. Until now, treatment of choice is complete surgical resection in its different modalities according to the degree of affected area.
Conclusions: The cavernous hemangioma is a vascular injury that manifests clinically as fresh transanal bleeding- We must consider this entity as differential diagnosis of the more common diseases at the anorectal level, by having a negative anoscopy, and not take the patient to an erroneous surgery due to a wrong diagnosis.
||Rectum, transanal bleeding, cavernous hemangioma, phleboliths.
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>Year 2011, Issue 3