[Cavernous hemangioma of the rectum--a rare differential per anal hemorrhage diagnosis].
A 19-year-old woman suffered from recurrent peranal hemorrhage. Over a period of five years she was treated under the suspicion of ulcerative colitis. After a sigmoid resection with a colostomy, proctectomy with an end colostomy followed due to recurrent intractable peranal hemorrhage. Histology of the specimen showed surprisingly a hemangioma of the rectum. Thereafter reconstruction was performed by colopouchanal anastomosis. Afterwards the patient was free of disease and had a good stool-continence. Stool-frequency was twice daily. The second case consisted in a 27-year-old woman who underwent emergency sigmoidectomy due to massive peranal hemorrhage. Here as well diagnosis was a hemangioma of the sigmoid. One year after the first operation the patient had a recurrence of peranal bleeding again due to rectal hemangioma. Since endoscopy and endosonography confirmed a rectal hemangioma a rectal exstirpation with a colopouchanal reconstruction was performed successfully. The reviewed literature shows including the two presented cases a total of 81 cases with rectal hemangiomas. Because of the good results concerning function and morbidity the therapy of choice is rectal exstirpation with colopouchanal reconstruction.
Kroesen
A J
AJ
Chirurgische Klinik I, Universitätsklinikum Benjamin Franklin-FU, Berlin.
Runkel
N
N
Becker
K
K
Buhr
H J
HJ
D000328:Adult; D000714:Anastomosis, Surgical; D003125:Colostomy; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D016737:Proctocolectomy, Restorative; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation