Anorectal hemangioma is one of the rarest causes of lower gastrointestinal bleeding, but is often neglected and confused in the differential diagnosis. The clinical examination is a turning point for a correct diagnosis and management of patients, thus avoiding unnecessary procedures. The treatment of choice for this condition is surgical and intraoperative bleeding is the main complication of this therapy. The present case reports a 25-year old patient with a history of bleeding from the age of 13, being diagnosed with anorectal hemangioma, and surgically treated with resection of the affected segment and with wound synthesis by marsupialization, with a good progression postoperatively.
Therefore, we will report the unusual case of a patient, who was submitted to surgery for suspected appendicitis and during the intraoperative period it was observed that he had diverticulitis of cecum. Case reportPatient, 42 years old, male, reported a lancinating pain in the lower right quadrant of the abdomen for 48 hours, associated with episodes of unmeasured fever and chills, denying vomiting, adynamia and changes in bowel habit. Physical examination revealed the presence of localized tenderness and painful decompression in right lower quadrant of abdomen, described as a Blumberg signal.A hemogram showed 9,800 leukocytes per mm 3 . The patient had undergone a surgical procedure. It was initially performed as a Davis incision, which revealed hyperemia of the vermiform appendix and inflammatory mass surrounding a perforated cecum. So, the surgical team changed to xipho-pubic incision in order to perform a ileotiflectomy. The bowel transit was reconstructed by side-to-side ileotransverse anastomosis. The patient recovered well in the postoperative staying and was discharged after 6 days. Histopathological examination revealed: diverticular disease of the colon with diverticulitis and perforation associated with lymphoid hyperplasia of the cecal appendix.
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