Vascular anomalies of the large bowel
G Pellino1, G Candilio, G S De Fatico
1Unit of Surgery, Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences, Second University of Naples, Naples, Italy - gipe1984@gmail.com.
Insights
Vascular malformations of the colon (VMC) are rare, potentially life-threatening conditions. Advances in endoscopic therapy improve treatment outcomes, but long-term follow-up is essential due to potential relapses.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Medical Diagnostics
Background:
- Vascular malformations of the colon (VMC) are rare conditions with potential for significant morbidity and mortality.
- These anomalies primarily affect individuals over 50, often presenting with lower gastrointestinal bleeding.
Purpose of the Study:
- To provide a practical, up-to-date summary of VMC.
- To review the pathogenesis, diagnostic, and therapeutic modalities for VMC.
Main Methods:
- A narrative review of existing literature on VMC.
- Discussion of diagnostic and therapeutic approaches.
Main Results:
- Over 70% of VMC occur in the cecum and ascending colon.
- Endoscopic identification and treatment are crucial; aggressive interventions are needed for treatment failures.
- Relapse rates can be as high as 40% in the long term.
Conclusions:
- VMC are rare but serious conditions requiring prompt management.
- Improved endoscopic techniques enhance treatment success.
- Long-term patient follow-up is recommended to monitor for VMC recurrence.
Introduction:
Vascular anomalies of the large bowel, commonly referred to as vascular malformations of the colon (VMC) constitute a rare but important condition, potentially causing significant morbidity and mortality. Our aim is to provide an up-to-date, practical summary evaluating this disease entity, focussing on pathogenesis, as well as diagnostic and therapeutic modalities.
Materials And Methods:
We reviewed available data in the literature, and discussed it in the form of a narrative, readily applicable review.
Results:
Most VMC (over 70%) are detected in the caecum and ascending colon, and affect people aged over 50 years. VMC are almost always symptomatic, presenting with lower bleeding. Endoscopy is crucial to identify and locate VMC, and to treat the lesions. In patients who fail or do not fit endoscopic treatment, aggressive approaches (interventional angiology or surgery) are mandatory. Up to 40% of patients may have relapse in the long term.
Conclusions:
VMC are rare but potentially life-threatening. Advances in endoscopic imaging and therapy have improved the results of treatment. Long-term follow-up after treatment is recommended.
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