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Cecal polypoid arteriovenous malformations removed by endoscopic biopsy
Byung Kook Kim1, Hye Seung Han, Sun-Young Lee
1Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Journal of Korean Medical Science
|April 29, 2009
Summary
Colonic arteriovenous malformations (AVMs) can cause lower GI bleeding. This case highlights small, non-solitary cecal AVMs successfully treated with endoscopic biopsy, challenging typical AVM presentations.
Area of Science:
- Gastroenterology
- Vascular Medicine
- Endoscopic Surgery
Background:
- Colonic arteriovenous malformations (AVMs) are a recognized cause of lower gastrointestinal bleeding.
- Typically, colonic AVMs present as solitary, large, bright red lesions.
- This contrasts with smaller vascular ectasias or angiodysplasias.
Observation:
- A case report details a 66-year-old woman undergoing routine screening.
- Colonoscopy revealed three small, semi-pedunculated polyps near the appendiceal orifice.
- Initial gross examination suggested inflammatory polyps due to normal epithelium and converging folds.
Findings:
- Endoscopic biopsies were taken from the three cecal lesions.
- Histopathology confirmed the lesions as polypoid colonic AVMs, characterized by intramucosal hemorrhage and dilated submucosal vessels.
- Bleeding from the biopsy sites resolved spontaneously.
Implications:
- This case expands the endoscopic and histopathological spectrum of colonic AVMs.
- It demonstrates that non-solitary, small AVMs in the cecum can be diagnosed and managed via endoscopic biopsy.
- This finding is crucial for accurate diagnosis and treatment of gastrointestinal bleeding sources.
