Choi Youn Jung, Jee Sam Ryong, Park Kwan Sik, Ryu Choong Heon, Seo Hyo Rim, Ha Seoung In, Lee Sang Heon, Ok Kyung Sun
Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Korea.
Korean J Gastroenterol. 2011 Sep 25;58(3):157-61. doi: 10.4166/kjg.2011.58.3.157.
Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.
克-特综合征(KTS)的特征为受累肢体的皮肤血管痣、肢体的骨骼和软组织肥大以及静脉畸形。我们报告一例伴有脾血管瘤和直肠静脉曲张的KTS病例。一名29岁女性因数年的间歇性便血前来就诊。她自1岁起就有多次皮肤和软组织血管瘤手术史,且在过去几个月左大腿周长增加。腹部CT显示脾脏有多个血管瘤、深部静脉梭形动脉瘤样扩张以及软组织血管瘤。没有肝脾肿大或肝硬化的证据。结肠镜检查显示直肠有血管瘤累及。有直肠静脉曲张,但无活动性出血迹象。对左腿进行静脉造影时,我们还发现皮下组织有浸润性扩张的浅静脉以及深部静脉的动脉瘤样扩张。该患者最终被诊断为KTS,仅接受口服铁剂补充治疗,迄今为止耐受性良好。无需进行干预或手术。当在无明确潜在病因的年轻患者中检测到胃肠道静脉曲张或血管瘤性黏膜改变时,应考虑KTS。