Kishi K, Takahashi S, Sawata T, Furumoto T, Kawamura Y, Kato K
Department of Surgery, Tottori Prefectural Central Hospital, Japan.
Surg Today. 1994;24(9):833-6. doi: 10.1007/BF01636317.
We report herein the case of a 28-year-old woman with a rectal cavernous hemangioma in whom recurrent rectal bleeding and marked anemia were interpreted as being caused by her coexisting internal hemorrhoids, resulting in a delay in the correct diagnosis for 1 year. Digital examination revealed a walnut-sized, wide-based, and elastic soft mass, 3 cm proximal from the anal verge, in addition to the internal hemorrhoids. Colonofiberscopy revealed a bluish submucosal lesion with superficial capillary dilatation at the same site. A transanal local resection was performed and the histological diagnosis of the tumor was cavernous hemangioma. The patient has been well without any recurrence of rectal bleeding for 2 years and 6 months since her operation. Thus, although rectal cavernous hemangioma is rare, a lack of awareness of this condition could lead to misdiagnosis as hemorrhoids and subsequent inappropriate therapy.
我们在此报告一例28岁患有直肠海绵状血管瘤的女性病例。该患者反复直肠出血并伴有明显贫血，最初被认为是由同时存在的内痔所致，导致正确诊断延误了1年。直肠指检发现除内痔外，在距肛缘3 cm处有一个核桃大小、基底较宽且质地有弹性的柔软肿物。纤维结肠镜检查显示同一部位有一个蓝色黏膜下病变，伴有浅表毛细血管扩张。遂行经肛门局部切除术，术后病理诊断为海绵状血管瘤。自手术以来，患者情况良好，直肠出血未再复发，至今已有2年6个月。因此，尽管直肠海绵状血管瘤较为罕见，但对该病认识不足可能导致误诊为痔疮并进而进行不恰当的治疗。
