Abstract
A 25-year-old female was referred to the Interventional Radiology Department for investigation and treatment of a rectal venous malformation (RVM) causing large recurrent episodes of rectal bleeding and chronic anaemia. Magnetic resonance imaging (MRI) demonstrated a large venous malformation affecting the rectum, lower pelvis and left thigh. After three failed attempts at injection foam sclerotherapy using fluoroscopic colonoscopy, a multidisciplinary team proposed an embolization procedure of the arterial inflow to the venous malformation. Following discussion with the patient, embolization of the superior rectal arteries was undertaken with immediate on-table fluoroscopic improvement in the RVM. Post-treatment, a significant reduction in bleeding, was reported by day 10 with subsequent return to activities of daily living and full employment. Follow-up MRI at 1 year demonstrated significant reduction in bowel-wall thickening.
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References
Christenson BM, Gipson MG, Smith MT. Pelvic vascular malformations. Semin Interv Radiol. 2013;30(4):364–71.
Azizkhan RG. Life-threatening hematochezia from a rectosigmoid vascular malformation in Klippel-Trenaunay syndrome: long-term palliation using an argon laser. J Pediatr Surg. 1991;26(9):1125–7 (discussion 8).
Wilson CL, Song LM, Chua H, Ferrara M, Devine RM, Dozois RR, et al. Bleeding from cavernous angiomatosis of the rectum in Klippel-Trenaunay syndrome: report of three cases and literature review. Am J Gastroenterol. 2001;96(9):2783–8.
Parashette KR, Cuffari C. Sclerotherapy of rectal hemangiomas in a child with Klippel-Trenaunay-Weber syndrome. J Pediatr Gastroenterol Nutr. 2011;52(1):111–2.
Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol. 1995;90(4):610–3.
Noel AA, Gloviczki P, Cherry KJ Jr, Rooke TW, Stanson AW, Driscoll DJ. Surgical treatment of venous malformations in Klippel-Trenaunay syndrome. J Vasc Surg. 2000;32(5):840–7.
Vidal V, Sapoval M, Sielezneff Y, De Parades V, Tradi F, Louis G, et al. Emborrhoid: a new concept for the treatment of hemorrhoids with arterial embolization: the first 14 cases. Cardiovasc Interv Radiol. 2015;38(1):72–8.
Fishman SJ, Shamberger RC, Fox VL, Burrows PE. Endorectal pull-through abates gastrointestinal hemorrhage from colorectal venous malformations. J Pediatr Surg. 2000;35(6):982–4.
Yiannakopoulou E. Safety concerns for sclerotherapy of telangiectases, reticular and varicose veins. Pharmacology. 2016;98(1–2):62–9.
Burrows PE. Vascular malformations involving the female pelvis. Semin Interv Radiol. 2008;25(4):347–60.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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El-Sheikha, J., Little, M.W. & Bratby, M. Rectal Venous Malformation Treated by Superior Rectal Artery Embolization. Cardiovasc Intervent Radiol 42, 154–157 (2019). https://doi.org/10.1007/s00270-018-2067-0
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DOI: https://doi.org/10.1007/s00270-018-2067-0