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Intestinal vascular anomalies in children
B Frémond1, S Yazbeck, J Dubois
1Department of Radiology, Hôpital Sainte-Justine, Montreal, Quebec, Canada.
Journal of Pediatric Surgery
|June 1, 1997
Summary
Intestinal vascular anomalies are rare causes of childhood gastrointestinal bleeding. Angiography is crucial for diagnosis and precise localization, enabling effective surgical or conservative treatment.
Area of Science:
- Pediatric Gastroenterology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Gastrointestinal bleeding in children can stem from uncommon vascular anomalies.
- Confusing nomenclature complicates diagnosis and treatment consensus for these lesions.
Purpose of the Study:
- To clarify the diagnosis and management of intestinal vascular anomalies in children.
- To propose a classification based on natural history and clinical findings.
Main Methods:
- Retrospective review of pediatric patients with intestinal vascular anomalies (1975-1995).
- Analysis of clinical presentation, diagnostic methods (primarily angiography), treatment, and pathology.
- Identification of lesion types: isolated venous malformations and arteriovenous malformations.
Main Results:
- Thirteen lesions were identified in nine children; median onset age was 8 years.
- Angiography was essential for diagnosis and localization; intraoperative identification was challenging.
- Pathology revealed dilated veins in the mucosa and submucosa.
Conclusions:
- Selective angiography is vital for diagnosing gastrointestinal bleeding when other investigations are negative.
- Precise preoperative angiographic localization is essential for safe and limited surgical resection.
- A proposed classification aims to improve understanding and management of these anomalies.