Hayakawa H, Kusagawa M, Takahashi H, Okamura K, Kosaka A, Mizumoto R, Katsura K
Department of Surgery, Matsusaka City Hospital, Mie, Japan.
Surg Today. 1998;28(11):1182-7. doi: 10.1007/s005950050310.
We report herein the case of a 38-year-old man found to have a rectal arteriovenous malformation (AVM). The patient was admitted to our hospital for investigation of fresh anal bleeding and general malaise. Barium-enema examination showed a slightly elevated lesion in the rectum, and a selective superior rectal angiogram subsequently revealed an AVM in the peripheral region of the superior rectal artery, which was presumed to be the cause of the anal bleeding. Colonoscopic examination disclosed a submucosal tumor-like lesion in the left posterior wall of the rectum, 3cm above the anal verge. After marking the boundaries by clipping, transanal resection of the lesion was performed. Histological examination revealed an irregularly expanded arteriovenous aggregation in the submucosal layer. The patient had a favorable postoperative course, and no residual AVM was seen on a postoperative selective inferior mesenteric arteriogram. There have been no signs of recurrence in the 2 years since his operation.
我们在此报告一例38岁男性被发现患有直肠动静脉畸形（AVM）的病例。该患者因新鲜便血和全身不适入院接受检查。钡灌肠检查显示直肠有一处轻度隆起病变，随后选择性直肠上动脉血管造影显示在直肠上动脉周边区域存在一个AVM，推测这是便血的原因。结肠镜检查发现距肛缘3cm处直肠左后壁有一个黏膜下肿瘤样病变。通过钳夹标记边界后，经肛门切除该病变。组织学检查显示黏膜下层有不规则扩张的动静脉聚集。患者术后恢复良好，术后选择性肠系膜下动脉造影未见残留AVM。自手术以来的两年里没有复发迹象。
