Colo-anal sleeve anastomosis in the treatment of diffuse cavernous haemangioma involving the rectum

Abstract

An operative technique, involving a colo-anal sleeve anastomosis, is described for the treatment of cavernous haemangioma of the rectum. All the patients with this condition treated since 1930 at St Mark's Hospital are reviewed, and the presentation and results of treatment in the last 5 patients who have had a resection and colo-anal sleeve anastomosis are discussed.

Diffuse cavernous hemangioma of the rectum: MR imaging with endorectal surface coil and sphincter-saving surgery

“…Colorectal hemangioma has been variously misdiagnosed as internal hemorrhoids, inflammatory bowel disease, tuberculosis, carcinoma, and adenomatous polyps. 6-8 Jeffery et al 9 reported that hemorrhoidectomy was the most frequent procedure performed on patients with a rectal hemangioma before the age of 20, prior to definitive surgery. 9 The diagnosis of diffuse cavernous hemangioma of the rectum is not difficult.…”

“…6-8 Jeffery et al 9 reported that hemorrhoidectomy was the most frequent procedure performed on patients with a rectal hemangioma before the age of 20, prior to definitive surgery. 9 The diagnosis of diffuse cavernous hemangioma of the rectum is not difficult. The clinical triad of earlyonset recurrent painless rectal bleeding; multiple ectopic phleboliths on pelvic radiographs; and mucocutaneous hemangiomas (of the skin, lips, mouth, tongue) provides the major indication for the diagnosis.…”

Diffuse Cavernous Hemangioma of the Rectum and Sigmoid Colon

“…Vascular malformations of the gastrointestinal tract causing hemorrhage were first described by Philip in 1829 [3]. They usually involve the entire rectum, portions of the rectosigmoid and perirectal tissues.…”

“…Plain film radiographs and computer tomography may show pelvic phleboliths in the area of the rectal wall. Barium enema reveals multiple polypoid lesions in the submucosa and narrowing of the colonic lumen [1, 3, 6, 8]. Arteriographies show venous pooling and vascular proliferation in the rectal or rectosigmoid region [5, 9, 10].…”

“…In recent years, sphincter-saving procedures have become popular if hemorrhage can be controlled and there is no evidence of malignant change [11]. Low anterior resection with a minimal rectal cuff left in place, rectal mucosectomy and colo-anal pull-through are the most favorable sphincter-saving procedures [1, 3, 5, 8, 9, 11]. …”