Yoo Stephen
Division of Colon and Rectal Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Clin Colon Rectal Surg. 2011 Sep;24(3):193-200. doi: 10.1055/s-0031-1286003.
Hemangiomas and vascular malformations of the gastrointestinal tract, rare clinical entities, present as overt or occult bleeding. They can be distributed throughout the intestinal digestive system, or present as a singular cavernous hemangioma or malformation, which is often located in the rectosigmoid region. Misdiagnosis is common despite characteristic radiographic features such as radiolucent phleboliths on plain film imaging and a purplish nodule on endoscopy. Adjunctive imaging such as computed tomography and magnetic resonance imaging are suggested as there is potential for local invasion. Endorectal ultrasound with Doppler has also been found to be useful in some instances. Surgical resection is the mainstay of treatment, with an emphasis on sphincter preservation. Nonsurgical endoscopic treatment with banding and sclerotherapy has been reported with success, especially in instances where an extensive resection is not feasible.
胃肠道血管瘤和血管畸形是罕见的临床病症，表现为显性或隐性出血。它们可分布于整个肠道消化系统，或表现为单个海绵状血管瘤或畸形，后者常位于直肠乙状结肠区域。尽管有特征性的影像学表现，如平片上的透光静脉石和内镜检查时的紫色结节，但误诊仍很常见。鉴于存在局部侵袭的可能性，建议采用计算机断层扫描和磁共振成像等辅助成像检查。经直肠超声检查结合多普勒在某些情况下也很有用。手术切除是主要的治疗方法，重点是保留括约肌。据报道，采用套扎和硬化疗法的非手术内镜治疗取得了成功，尤其是在无法进行广泛切除的情况下。
