Ganesananthan Sashiananthan, Barlow Jonathan, Durai Dharmaraj, Hawthorne Antony Barney
School of Medicine, Cardiff University, Cardiff, UK.
Gastroenterology, University Hospital of Wales, Cardiff, UK.
BMJ Case Rep. 2019 Mar 21;12(3):e227700. doi: 10.1136/bcr-2018-227700.
Venous or cavernous malformations of the colon or rectum are a rare cause of lower gastrointestinal bleeds. It has been previously described as a diffuse cavernous haemangioma which was thought to be a benign vascular tumour. It mainly affects the rectosigmoid area of the gastrointestinal tract and is most common in children and young adults. Misdiagnosis is common with patients averaging a total of 19 years delay to this final diagnosis. We report a case of a 65-year-old patient who presented with occult, painless rectal bleeding and prior to this presentation, had been managed variously as colitis and angiodysplasia. This article aims to delineate the updated classification of this disease, principal clinical clues to aid the diagnosis while discussing patient treatment options and potential challenges faced in patient management.
结肠或直肠的静脉性或海绵状畸形是下消化道出血的罕见原因。它先前被描述为弥漫性海绵状血管瘤，被认为是一种良性血管肿瘤。它主要影响胃肠道的直肠乙状结肠区域，在儿童和年轻人中最为常见。误诊很常见，患者平均延迟19年才得到最终诊断。我们报告一例65岁患者，该患者出现隐匿性、无痛性直肠出血，在此之前，曾被诊断为结肠炎和血管发育异常并接受了相应治疗。本文旨在阐述该疾病的最新分类、有助于诊断的主要临床线索，同时讨论患者的治疗选择以及患者管理中面临的潜在挑战。
