[Congenital angiodysplasias of the large intestine]

Angiodysplasia is a rare disease of the intestinal vessels. One of its types is the congenital form (so-called hemangioma or vascular hamartoma) which is mostly encountered at young age. Forty-eight patients with congenital forms of angiodysplasia of the large intestine were treated at the Scientific Research Institute of Proctology, RF Ministry of Health, beginning from 1962. According to morphological structure, there were 26 cases of the cavernous type, 11 of the capillary type, 11 of the mixed forms. In 46 of 48 patients the rectum and sigmoid were involved in the pathological process. Intestinal bleeding of various degree and intensity, occurring in 40 patients from early childhood, was the principal symptom in the clinical picture of the disease. The endoscopic picture of congenital angiodysplasia of the large intestine has characteristic macroscopic signs. Irrigoscopy and angiography are also very valuable and informative methods in the diagnosis of this form. Surgical interventions were performed on 28 patients, which accounted for 58.3% of the total number of patients with congenital angiodysplasia. Profuse bleeding leading to stable anemization of the patient is an indication for surgery. The volume of the operation was determined by the localization and spread of the pathological process. In concurrent localization of dysplasias, particularly in the pelvic cavity, and bearing in mind the seriousness of the operation itself, the degree of intraoperative blood loss, and the technical peculiarities of the intervention we prefer many-stage treatment. We encountered 18 complications, which mainly developed on the part of the perineum.