A rare cause of rectal bleeding masquerading as proctitis

Area of Science:

• Gastroenterology
• Surgical Oncology
• Vascular Neoplasms

Background:

• Diffuse cavernous haemangioma of the rectum (DCHR) is a rare, benign vascular tumor primarily affecting young adults.
• DCHR commonly presents with rectal bleeding, ranging from mild to massive hemorrhage, and can be misdiagnosed.
• This report details a unique case of DCHR initially presenting as proctitis.

Observation:

• The patient's DCHR was misdiagnosed as proctitis for many years, underscoring diagnostic challenges.
• Colonoscopy was instrumental in the initial, albeit delayed, diagnosis of DCHR.
• This case represents the first documented instance of DCHR resection utilizing a colonic J-pouch reconstruction.

Findings:

• The study emphasizes the rarity of DCHR and its potential for misdiagnosis as proctitis.
• Surgical resection was performed, followed by reconstruction using a colonic J-pouch.
• This approach aimed to optimize bowel function post-operatively, contrasting with conventional colo-anal anastomosis.

Implications:

• Increased clinical awareness of DCHR is crucial for accurate diagnosis and timely surgical intervention.
• Prompt management of DCHR can prevent severe rectal hemorrhage and avoid unnecessary treatments.
• J-pouch reconstruction offers a potentially superior functional outcome compared to traditional methods after DCHR resection.