Colonic Polypoid Arteriovenous Malformation Causing Symptomatic Anemia

Abstract

Vascular ectasias, which can be classified as angiodysplasias and arteriovenous malformations (AVMs), accounts for approximately 3% of lower gastrointestinal bleeding. Typically, colonic AVMs are solitary, large, and flat or elevated red lesions on endoscopy. We present an interesting case of a polypoid ulcerated AVM in the transverse colon causing symptomatic anemia, which was resected endoscopically with a resolution of symptoms. Polypoid colonic AVMs are rather rare with only 15 other cases described in the literature. This case highlights the approach to endoscopic management of these lesions.

Figure 1.

An endoscopic view of the 3-cm semipedunculated ulcerated mass in the proximal transverse colon.

Figure 2.

Biopsy of the excised polyp showing distended submucosal vascular channels. The overlying mucosa shows no adenomatous changes (hematoxylin and eosin stain 20× magnification).

Figure 3.

Biopsy of the excised polyp showing details of the distended submucosal vascular channels, which includes both larger thin-walled veins and smaller thick-walled arterial branches (hematoxylin and eosin stain 40× magnification).