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. 2011 Sep;24(3):193-200.
doi: 10.1055/s-0031-1286003.

GI-Associated Hemangiomas and Vascular Malformations

Stephen Yoo  1
Affiliations

GI-Associated Hemangiomas and Vascular Malformations

Stephen Yoo. Clin Colon Rectal Surg. 2011 Sep.

Abstract

Hemangiomas and vascular malformations of the gastrointestinal tract, rare clinical entities, present as overt or occult bleeding. They can be distributed throughout the intestinal digestive system, or present as a singular cavernous hemangioma or malformation, which is often located in the rectosigmoid region. Misdiagnosis is common despite characteristic radiographic features such as radiolucent phleboliths on plain film imaging and a purplish nodule on endoscopy. Adjunctive imaging such as computed tomography and magnetic resonance imaging are suggested as there is potential for local invasion. Endorectal ultrasound with Doppler has also been found to be useful in some instances. Surgical resection is the mainstay of treatment, with an emphasis on sphincter preservation. Nonsurgical endoscopic treatment with banding and sclerotherapy has been reported with success, especially in instances where an extensive resection is not feasible.

Keywords: Hemangioma; blue rubber bleb; cavernous hemangioma; vascular malformation.

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Figures

Figure 1
Figure 1
Cavernous vascular malformation. It is composed of blood-filled sinus-like spaces with prominent vascular channels in the submucosa. (Left: hematoxylin & eosin [H&E] 4x; right: H&E 10x.)
Figure 2
Figure 2
Computed tomography reconstruction, simulating plain film imaging, shows the characteristic phleboliths and their typical distribution.
Figure 3
Figure 3
Barium enema. Multiple submucosal polypoid masses can be seen throughout, but especially in the rectosigmoid.
Figure 4
Figure 4
Computed tomography scan shows marked thickening of the rectosigmoid wall with phleboliths.
Figure 5
Figure 5
T2-weighted magnetic resonance imaging shows rectal wall thickening (arrow) and perirectal serpiginous vascularity (star).
Figure 6
Figure 6
Endorectal ultrasound (ERUS) demonstrates sponge-like nature of malformation. Not well represented is the duplex flow that is specific for identifying the vascular component.
Figure 7
Figure 7
Endoscopic view. A polypoid, purple nodule is seen. (Color not shown.)
See this image and copyright information in PMC

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