Wen Ping-Hua, Hu Bing
Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastrointest Surg. 2025 Jan 27;17(1):100108. doi: 10.4240/wjgs.v17.i1.100108.
In this manuscript, I comment on the article by Pospisilova published in the recent issue of the journal, in which selective embolization was used to treat anorectal hemangioma, a rare disease causing lower gastrointestinal bleeding. Anorectal hemangioma can easily be mistaken; for example, the patient in this case was previously misdiagnosed with ulcerative colitis. Choosing the appropriate tests and understanding the typical manifestations of anorectal hemangioma under colonoscopy, computerized tomography, magnetic resonance imaging and other tests are beneficial for diagnosis. The patient presented with intermittent rectal bleeding despite treatment with azathioprine and mesalazine and required blood transfusions since the degree of rectal bleeding worsened. Selective embolization successfully alleviated the patient's bleeding symptoms and avoided the need for repeated blood transfusions. Tranexamic acid may be useful, considering that the patient still has bleeding symptoms and requires parenteral iron supplementation.
在本手稿中，我对Pospisilova发表于该杂志最近一期的文章进行评论，该文章中使用选择性栓塞治疗引起下消化道出血的罕见疾病——肛肠血管瘤。肛肠血管瘤很容易被误诊；例如，该病例中的患者之前被误诊为溃疡性结肠炎。选择合适的检查方法并了解在结肠镜检查、计算机断层扫描、磁共振成像等检查下肛肠血管瘤的典型表现，有助于诊断。尽管使用硫唑嘌呤和美沙拉嗪进行了治疗，该患者仍出现间歇性直肠出血，且由于直肠出血程度加重需要输血。选择性栓塞成功缓解了患者的出血症状，避免了反复输血的需要。考虑到患者仍有出血症状且需要胃肠外补充铁剂，氨甲环酸可能会有用。
