Rectal Arteriovenous Malformation Treated by Transcatheter Arterial Embolization

Area of Science:

• Gastroenterology
• Vascular Surgery
• Interventional Radiology

Background:

• Rectal arteriovenous malformations (AVMs) are rare vascular anomalies that can present with significant gastrointestinal bleeding.
• Diagnosis can be challenging due to their submucosal location and resemblance to other rectal lesions.

Observation:

• An 86-year-old male presented with frequent hematochezia and mild anemia.
• Colonoscopy revealed a submucosal tumor-like lesion in the lower rectum.
• Imaging (CT, MRI, angiography) demonstrated vascular hyperplasia and a nidus consistent with rectal AVM.

Findings:

• Transcatheter arterial embolization was performed using the superior, middle, and inferior rectal arteries.
• The embolization procedure successfully controlled the bleeding from the rectal AVM.
• The patient avoided the need for abdominoperineal resection.

Implications:

• Transcatheter arterial embolization is a viable, minimally invasive treatment option for rectal AVMs, particularly in elderly patients.
• This approach can effectively manage bleeding and prevent major surgery.
• Successful embolization offers a favorable outcome with no recurrence during a 10-month follow-up.