Abstract
An unusual case of a colonic vascular anomaly resembling angiodysplasia associated with right sided diverticular disease is presented. The patient, a 74 year old man, presented with a four day history of rectal bleeding and subsequently underwent hemicolectomy. The resected specimen was flushed out with heparin-saline solution and injected with a barium-gelatine mixture. Preoperative barium enema revealed right sided diverticula, whereas post-resection angioradiography revealed the "coral reef" vascular anomaly consistent with angiodysplasia. Histology confirmed the presence of both diverticular disease and angiodysplasia. This case report highlights the importance of considering a vascular anomaly in patients presenting with rectal bleeding despite the presence of another radiologically demonstrable anatomical lesion.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allison D. J., Hemingway A. P. Angiodysplasia: does old age begin at nineteen? Lancet. 1981 Oct 31;2(8253):979–980. doi: 10.1016/s0140-6736(81)91169-7. [DOI] [PubMed] [Google Scholar]
- Athanasoulis C. A., Galdabini J. J., Waltman A. C., Novelline R. A., Greenfield A. J., Ezpeleta M. L. Angiodysplasia of the colon: a cause of rectal bleeding. Cardiovasc Radiol. 1977;1(1):3–13. doi: 10.1007/BF02551967. [DOI] [PubMed] [Google Scholar]
- BIRD R. M., JAQUES W. E. Vascular lesion of hereditary hemorrhagic telangiectasia. N Engl J Med. 1959 Mar 19;260(12):597–599. doi: 10.1056/NEJM195903192601206. [DOI] [PubMed] [Google Scholar]
- Boley S. J., Sammartano R., Adams A., DiBiase A., Kleinhaus S., Sprayregen S. On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology. 1977 Apr;72(4 Pt 1):650–660. [PubMed] [Google Scholar]
- Cappell M. S., Lebwohl O. Cessation of recurrent bleeding from gastrointestinal angiodysplasias after aortic valve replacement. Ann Intern Med. 1986 Jul;105(1):54–57. doi: 10.7326/0003-4819-105-1-54. [DOI] [PubMed] [Google Scholar]
- GRIFFITHS J. D. Extramural and intramural blood-supply of colon. Br Med J. 1961 Feb 4;1(5222):323–326. doi: 10.1136/bmj.1.5222.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Galloway S. J., Casarella W. J., Shimkin P. M. Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis. Radiology. 1974 Oct;113(1):11–15. doi: 10.1148/113.1.11. [DOI] [PubMed] [Google Scholar]
- Mitsudo S. M., Boley S. J., Brandt L. J., Montefusco C. M., Sammartano R. J. Vascular ectasias of the right colon in the elderly: a distinct pathologic entity. Hum Pathol. 1979 Sep;10(5):585–600. doi: 10.1016/s0046-8177(79)80101-x. [DOI] [PubMed] [Google Scholar]
- Moore J. D., Thompson N. W., Appelman H. D., Foley D. Arteriovenous malformations of the gastrointestinal tract. Arch Surg. 1976 Apr;111(4):381–389. doi: 10.1001/archsurg.1976.01360220077013. [DOI] [PubMed] [Google Scholar]
- Perry P. M., Morson B. C. Right-sided diverticulosis of the colon. Br J Surg. 1971 Dec;58(12):902–904. doi: 10.1002/bjs.1800581208. [DOI] [PubMed] [Google Scholar]
- Pounder D. J., Rowland R., Pieterse A. S., Freeman R., Hunter R. Angiodysplasias of the colon. J Clin Pathol. 1982 Aug;35(8):824–829. doi: 10.1136/jcp.35.8.824. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Warkentin T. E., Moore J. C., Morgan D. G. Aortic stenosis and bleeding gastrointestinal angiodysplasia: is acquired von Willebrand's disease the link? Lancet. 1992 Jul 4;340(8810):35–37. doi: 10.1016/0140-6736(92)92434-h. [DOI] [PubMed] [Google Scholar]
- Welch C. E., Athanasoulis C. A., Galdabini J. J. Hemorrhage from the large bowel with special reference to angiodysplasia and diverticular disease. World J Surg. 1978 Jan;2(1):73–83. doi: 10.1007/BF01574466. [DOI] [PubMed] [Google Scholar]