Vascular malformations of the colon in children

Torre, Luís de la; Carrasco, Daniel Kent; Mora, Ma.Antonieta; Ramírez-Arbeláez, Jaime Alberto; López, Secundino

doi:10.1053/jpsu.2002.36714

Cited by 41 publications

(20 citation statements)

References 20 publications

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“…Previous literature has shown that up to 83% of gastrointestinal vascular malformations are known to cause lower gastrointestinal bleeding and are located in the rectum and sigmoid 13,14 . As bleeding is the most common symptom of both hemangiomas and VMs, and because there are various therapies available 15 , an exact diagnosis is critical.…”

Section: Discussionmentioning

confidence: 99%

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Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Brill

Brill²,

Uller

et al. 2019

Sci Rep

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The aim of this study was to identify the frequency of rectosigmoidal involvement in patients with venous malformations (VM) of the lower extremities and to demonstrate multidisciplinary therapeutic options. The medical records and magnetic resonance images (MRI) of patients with VM of the lower extremities, over a six-year period, were reviewed retrospectively in order to determine the occurrence of rectosigmoidal involvement. Vascular interventions, surgical treatments, percutaneous and hybrid (endoscopy-guided angiography) sclerotherapy and procedural complications (according to Clavien-Dindo classification) were also noted. Of the 378 patients with vascular malformation of the lower limbs, 19 patients (5%) had documented venous rectosigmoidal malformation. All of these 19 patients reported episodes of rectal bleeding, while seven patients (36.8%) also had anemia. All patients underwent endoscopy. By endoscopy, seven patients (36.8%) showed discreet changes, and 12 patients (63.2%) showed pronounced signs of submucosal VM with active (47.3%) or previous (15.7%) bleeding. Treatment was performed in all patients with pronounced findings. Six patients underwent endoscopy-guided hybrid sclerotherapy, one patient underwent endoscopic tissue removal, one patient received percutaneous sclerotherapy and one patient received a combination of transvenous embolization and hybrid sclerotherapy. Three patients required open surgery. No complications occurred after conservative treatments; however, one complication was reported after open surgery. None of the treated patients reported further bleeding and anemia at the end of the follow-up period. In this cohort, rectosigmoidal VM occurred in 5% of patients presenting with a high incidence of rectal bleeding. Percutaneous or endoscopy-guided hybrid sclerotherapy appeared to be a safe and effective alternative to surgery.

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Section: Discussionmentioning

confidence: 99%

“…In the literature, case reports or small case series of laparoscopic or open surgical treatment of vascular malformations of the colon have been reported 13,14,28,29 , but a combination of treatment options or comparison to conservative therapies are lacking. Resection can be a valuable option if the lesion can be eliminated completely 5 .…”

Section: Discussionmentioning

confidence: 99%

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Brill

Brill²,

Uller

et al. 2019

Sci Rep

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“…childhood hemangiomas, intestinal VM are characterized biologically by the absence of growth or by spontaneous regression. These are congenital dysplastic vessels resulting from errors in vascular morphogenesis [5]. VM can be further subdivided into low-and high-flow malformations, which would reflect their capillary-venous and arterial origin, respectively [6].…”

Section: Discussionmentioning

confidence: 99%

“…While coagulation and embolization are suitable options for treatment regarding VM of solid organs, using these modalities in hollow viscus puts them at risk for ischaemia and necrosis. While right hemicolectomy is the most common surgical procedure performed in adults with vascular anomalies of the colon, in children, the left hemi-colon and rectum are the more frequently affected segments, rendering surgical therapy a challenge [10].…”

Section: Discussionmentioning

confidence: 99%

Hematochezia in a 1.5-Year-Old Child Diagnosed as a Colonic Arteriovenous Malformation

Jacob¹,

Ben²,

Kravarušić³

2020

SCR

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Vascular anomalies are an uncommon cause of gastrointestinal bleeding in childhood. These malformations may present with diverse symptoms, while gastrointestinal bleeding is the most common. Regarding diagnosis, these lesions may be detected by endoscopy, but only the mucosal component of them is assessable by this modality. Definitive diagnosis is best achieved by selective mesenteric angiography. We report a rare case of a 1.5-year-old child who presented with the complaint of hematochezia, which, after examination and evaluation, was found to be due to an intestinal arteriovenous malformation. Therapy of these malformations includes different modalities such as coagulation, embolization and surgical resections. Reviewing the literature, this is the first report in pediatric surgery literature of the laparoscopic approach for symptomatic high flow arteriovenous malformation, especially at this incredibly young age.

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“…More rarely, vascular malformations of the colon or small intestine are observed [32]. If the GI endoscopic findings are normal, thus discounting rupture of varices, scintigraphy or even surgical exploration should be performed to search for a Meckel’s diverticulum [33].…”

Section: Reviewmentioning

confidence: 99%

Management by the intensivist of gastrointestinal bleeding in adults and children

et al. 2012

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Intensivists are regularly confronted with the question of gastrointestinal bleeding. To date, the latest international recommendations regarding prevention and treatment for gastrointestinal bleeding lack a specific approach to the critically ill patients. We present recommendations for management by the intensivist of gastrointestinal bleeding in adults and children, developed with the GRADE system by an experts group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF), with the participation of the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP), the French Society of Emergency Medicine (SFMU), the French Society of Gastroenterology (SNFGE), and the French Society of Digestive Endoscopy (SFED). The recommendations cover five fields of application: management of gastrointestinal bleeding before endoscopic diagnosis, treatment of upper gastrointestinal bleeding unrelated to portal hypertension, treatment of upper gastrointestinal bleeding related to portal hypertension, management of presumed lower gastrointestinal bleeding, and prevention of upper gastrointestinal bleeding in intensive care.

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Vascular malformations of the colon in children

Cited by 41 publications

References 20 publications

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Hematochezia in a 1.5-Year-Old Child Diagnosed as a Colonic Arteriovenous Malformation

Management by the intensivist of gastrointestinal bleeding in adults and children

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