Hong Jihoon, Lee Sang Yub, Cha Jung Guen, Heo Jun
Department of Radiology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Case Rep Gastroenterol. 2021 Mar 3;15(1):262-268. doi: 10.1159/000513147. eCollection 2021 Jan-Apr.
Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percutaneous transarterial ethanol sclerotherapy. The patient underwent routine colonoscopy with biopsy at the time of visit; however, an accurate diagnosis was difficult. Subsequent contrast-enhanced computed tomography (CT) and angiography revealed a rectal AVM emerging from the distal inferior mesenteric artery with engorged superior rectal veins. The feeding artery was catheterized, and concurrent transarterial sclerotherapy with 80% ethanol was performed. There was no major complication related to the procedure. Disappearance of AVM nidus and improvement of associated venous congestion were shown by follow-up CT. There was no recurrence of symptoms after 10 months of clinical observation. Transarterial ethanol sclerotherapy is safe and effective in treating rectal AVM and can be considered as one of the nonsurgical treatment options.
胃肠道动静脉畸形（AVM）被报道为肠道出血的可能原因之一，其在直肠的发生较为罕见。我们报告了一例直肠AVM患者，该患者出现了肛门疼痛和里急后重等不常见症状，并通过经皮经动脉乙醇硬化疗法成功治愈。患者就诊时接受了常规结肠镜检查及活检；然而，准确诊断较为困难。随后的增强计算机断层扫描（CT）和血管造影显示，直肠AVM起源于肠系膜下动脉远端，伴有直肠上静脉充血。对供血动脉进行插管，并同时用80%乙醇进行经动脉硬化治疗。该操作未出现重大并发症。随访CT显示AVM病灶消失，相关静脉充血改善。临床观察10个月后症状未复发。经动脉乙醇硬化疗法治疗直肠AVM安全有效，可被视为非手术治疗选择之一。
