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Diagnostics and surgical treatment strategy for rectal cavernous hemangiomas based on three case examples
U Pohlen1, A J Kroesen, G Berger
1Surgical Department I, University Hospital Benjamin Franklin, Free University of Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany.
International Journal of Colorectal Disease
|February 9, 2000
Summary
Surgical management of rectal hemangiomas, rare vascular malformations, can be complex. Coloanal pouch anastomosis offers a promising approach for preserving continuity and continence in patients with these challenging conditions.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Colorectal Surgery
Background:
- Rectal hemangiomas are rare congenital vascular malformations.
- These malformations can cause significant perianal bleeding, leading to anemia and requiring frequent transfusions.
- Surgical intervention is often necessary for intractable bleeding and to improve patient quality of life.
Observation:
- Three cases of young patients (20-year-old man, 27-year-old woman, 19-year-old woman) with significant perianal bleeding due to rectal and sigmoid hemangiomas are presented.
- Initial treatments varied, including conservative management and emergency resections.
- Recurrent hemorrhages necessitated further surgical procedures in all cases.
Findings:
- Deep anterior rectosigmoid resection with coloanal pouch anastomosis was performed in one patient.
- Coloanal pouch reconstruction was performed in a second step for another patient after emergency resection.
- Proctectomy with descendostoma creation was initially performed for severe bleeding, followed by reconstruction with coloanal pouch anastomosis in the third patient.
Implications:
- Coloanal pouch anastomosis appears to be an effective surgical technique for managing rectal hemangiomas.
- This approach facilitates the preservation of bowel continuity and fecal continence.
- Further studies are warranted to evaluate long-term functional outcomes and compare with other surgical modalities.