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Large-bowel hemangiomas

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Diseases of the Colon & Rectum

Abstract

A case of large-bowel hemangioma is presented, and radiologic and histologic abnormalities are illustrated. Ultrasonographic features, not previously described, are reported. The literature is reviewed and the frequency of misdiagnosis is emphasized. Pathologic classification, epidermiologic factors, and etiology are considered. Clinical manifestations and current approaches to recognition and management are summarized. Vascular tumors are serious, albeit uncommon, intestinal lesions. Greater awareness of the condition and earlier consideration of the diagnosis are prerequisites to lessened morbidity and improved survival.

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References

  1. Phillips B. Surgical cases. London Med Gaz 1839;23:514–7.

    Google Scholar 

  2. Bancroft FW. Haemangioma of sigmoid and colon. Ann Surg 1931;94:828–38.

    Article  PubMed  CAS  Google Scholar 

  3. Ackerman LV. Cavernous hemangiomata of small and large bowel. Am J Cancer 1937;30:753–7.

    Google Scholar 

  4. Hunt VC. Hemangioma of the large bowel. Surgery 1941;10:651–60.

    Google Scholar 

  5. Lazarus JA, Marks MS. Benign intestinal tumors of vascular origin. Surgery 1947;22:766–79.

    PubMed  CAS  Google Scholar 

  6. Gentry RW, Dockerty MB, Clagett OT. Vascular malformations and vascular tumors of the gastrointestinal tract. Int Abstr Surg 1949;88:281–323.

    CAS  Google Scholar 

  7. Hellstrom J, Hultborn KA, Engstedt L. Diffuse cavernous hemangioma of the rectum. Acta Chir Scand 1955;109:277–83.

    CAS  PubMed  Google Scholar 

  8. Marine R, Lattomus WW. Cavernous hemangioma of the gastrointestinal tract. Radiology 1958;70:860–3.

    CAS  PubMed  Google Scholar 

  9. Rissier HL. Hemangiomatosis of the intestine—discussion, review of the literature and report of two new cases. Gastroenterologia (Basel) 1960;93:357–69.

    Google Scholar 

  10. Condon RE, Loyd RD. Hemangioma of the colon. Am J Surg 1968;115:720–3.

    Article  CAS  PubMed  Google Scholar 

  11. Head HD, Baker JQ, Muir RW, Hemangioma of the colon. Am J Surg 1973;126:691–4.

    Article  CAS  PubMed  Google Scholar 

  12. Allred HW, Spencer RJ. Hemangiomas of the colon, rectum, and anus. Mayo Clin Proc 1974;49:739–41.

    PubMed  Google Scholar 

  13. Bargen JA, Dixon CF, The uncommon tumors of the large intestine. Am J Dig Dis 1934;1:400–3.

    Google Scholar 

  14. Stout AP. Tumors of the colon and rectum (excluding carcinoma and adenoma). In: Turell R, ed. Diseases of the colon and anorectum. 2nd ed. Philadelphia: WB Saunders, 1969;305–18.

    Google Scholar 

  15. Jaques AA. Cavernous hemangioma of the rectum and rectosigmoid colon. Am J Surg 1952;84:507–9.

    Article  CAS  PubMed  Google Scholar 

  16. Figliolini FJ, Cutait DE, deOliveira MR, Bastos Eda S. Rectosigmoidal hemangioma—report of two cases. Dis Colon Rectum 1962;4:349–55.

    Article  Google Scholar 

  17. Westerholm P. A case of diffuse haemangiomatosis of the colon and rectum. Acta Chir Scand 1967;133:173–6.

    Google Scholar 

  18. Stening SG, Heptinstall DI. Diffuse cavernous haemangioma of the rectum and sigmoid colon. Br J Surg 1970;57:186–9.

    CAS  PubMed  Google Scholar 

  19. Bell GA, McKenzie AD, Emmons H. Diffuse cavernous hemangioma of the rectum—report of a case and review of the literature. Dis Colon Rectum 1972;15:377–82.

    CAS  PubMed  Google Scholar 

  20. Babcock WW, Jonas KC. Hemangioma of the colon. Am J Surg 1950;80:854–9

    Article  CAS  PubMed  Google Scholar 

  21. Soave F. A new surgical technique for treatment of Hirschsprung's disease. Surgery 1964;56:1007–14

    CAS  PubMed  Google Scholar 

  22. Parker GW, Murney JA, Kenoyer WL. Cavernous hemangioma of the rectum and rectosigmoid. Dis Colon Rectum 1960;3:358–63

    CAS  PubMed  Google Scholar 

  23. Bland KI, Abney HT, MacGregor AMC, Hawkins IF. Hemangiomatosis of the colon and anorectrum. Am Surgeon 1974;40:626–35

    CAS  PubMed  Google Scholar 

  24. Ruiz-Moreno F. Hemangiomatosis of the colon. Dis Colon Rectum 1962;5:453–6

    CAS  PubMed  Google Scholar 

  25. Jeffery PJ, Hawley PR, Parks AG. Colo-anal sleeve anastomosis in the treatment of diffuse cavernous haemangioma involving the rectum. Br J Surg 1976;63:678–82

    CAS  PubMed  Google Scholar 

  26. Rutter AG. Submucous telangiectasis of the colon. Lancet 1956;2:1077–9

    Article  Google Scholar 

  27. Robbins SL, Cotran RS. Pathologic basis of disease. 2nd ed. Philadelphia: WB Saunders, 1979:635–6

    Google Scholar 

  28. Hansen PS. Hemangioma of the intestine. Am J Clin Pathol 1948;18:14–20.

    PubMed  CAS  Google Scholar 

  29. Wood DA. Tumors of the intestine. In: Atlas of tumor pathology (Sec IV). Washington, D.C.: Armed Forces Institute of Pathology, 1967:38–56.

    Google Scholar 

  30. Goldberg SM, Gordon PH, Nivatvongs S. Essentials of anorectal surgery. Philadelphia: JB Lippincott, 1980:176–8.

    Google Scholar 

  31. Calem WS, Jimenez FA. Vascular malformations of the intestine. Arch Surg 1963;86:571–9

    CAS  PubMed  Google Scholar 

  32. McKay ER, Clark HH. Mixed cavernous and capillary hemangiomatosis involving the large bowel. J Int Coll Surgeons 1957;27:218–21

    Google Scholar 

  33. Marishita R. Gastric hemangiomata. Jpn Arch Intern Med 1965;12:223–6

    Google Scholar 

  34. Nader PR, Margolin F. Hemangioma causing gastrointestinal bleeding. Am J Dis Child 1966;111:215–21

    CAS  PubMed  Google Scholar 

  35. Heycock JB, Dickinson PH. Haemangiomata of the intestine. Br Med J 1951;1:620–1

    CAS  PubMed  Google Scholar 

  36. Ehlert CP. Diffuse angiomatosis of the stomach, small intestine and colon. Chirurgie 1964;35:372–6

    Google Scholar 

  37. McIntosh N, Harris J. Multiple gastrointestinal haemangiomata. Br Med J 1970;4:600–2

    Article  CAS  PubMed  Google Scholar 

  38. Mellish RW. Multiple hemangiomas of the gastrointestinal tract in children. Am J Surg 1971;121:412–7

    Article  CAS  PubMed  Google Scholar 

  39. Kuffer FR, Starzynski TE, Girolami A, Murphy L, Grabstald H. Klippil-Trenaunay syndrome, visceral angiomatosis and thrombocytopenia. J Pediatr Surg 1968;3:65–72.

    Article  Google Scholar 

  40. Gascoyen M. Case of naevus including the parotid gland and causing death from suffocation—Naevi of viscera. Trans Pathol Soc London 1860;11:267–9

    Google Scholar 

  41. Weinstein EC, Moertel CG, Waugh JM. Intussuscepting hemangiomas of the gastro-intestinal tract. Ann Surg 1963;157:265–70

    Article  CAS  PubMed  Google Scholar 

  42. Berlyne GM, Berlyne N. Anaemia due to “blue-rubber-bleb” naevus disease. Lancet 1960;2:1275–7

    Article  Google Scholar 

  43. Pruzanski W. Intestinal and cutaneous hemangiomatosis. Am J Dig Dis 1963;8:200–4

    Article  Google Scholar 

  44. Hagood MF, Gathright JB. Hemangiomatosis of the skin and gastrointestinal tract. Dis Colon Rectum 1975;18:141–6

    CAS  PubMed  Google Scholar 

  45. Killingback M, Coombes B, Francis P. Intestinal and cutaneous haemangiomatosis. Med J Aust 1974;1:749–53

    CAS  PubMed  Google Scholar 

  46. Geschickter CF, Keasbey LE. Tumors of blood vessels. Am J Cancer 1935;12:568–91

    Google Scholar 

  47. Haubrich WS, Berk JE. Benign tumors of the colon and rectum—pathogenesis, clinical features and management. In: Bockus HL, ed. Gastroenterology, Vol 2. 3rd ed. Philadelphia: WB Saunders, 1976:1058–96

    Google Scholar 

  48. Ghahremani GG, Kangarloo H, Volberg F, Meyers MA. Diffuse cavernous hemangioma of the colon in the Klippel-Trenaunay syndrome. Radiology 1976;118:673–8

    CAS  PubMed  Google Scholar 

  49. Driscoll JE, Rabe MA. Hemorrhagic telangiectasis of the gastrointestinal tract—an obscure source of gastrointestinal bleeding. Am Surg 1954;20:1281–90

    CAS  PubMed  Google Scholar 

  50. Bartelheimer W, Remmele W, Ottenjann R. Colonoscopic recognition of hemangiomas in the colon ascendens. Endoscopy 1972;4:109–14

    Google Scholar 

  51. Rogers BHG, Adler F. Hemangiomas of the caecum—colonoscopic diagnosis and therapy. Gastroenterology 1976;71:1079–82

    CAS  PubMed  Google Scholar 

  52. Boley SJ, Sammartano R, Adamas A, DiBiase A, Kleinhause S, Spraygrens S. On the nature and etiology of vascular ectasias of the colon—degenerative lesions of aging. Gastroenterology 1977;72:650–60

    CAS  PubMed  Google Scholar 

  53. Hollingsworth G. Haemangiomatous lesions of the colon. Br J Radiol 1951;24:220–2

    Article  CAS  PubMed  Google Scholar 

  54. Vallette FN. Cavernous hemangioma of the rectum. Dis Colon Rectum 1970;13:344–5

    CAS  PubMed  Google Scholar 

  55. Sawyer CF. Hemangioma of the colon. Arch Surg 1939:39:987–91

    Google Scholar 

  56. Goligher JC. Surgery of the anus, rectum and colon. 4th ed. London. Bailliere Tindall, 1980:678–88

    Google Scholar 

  57. Skovgaard S, Sorrenson FH. Bleeding hemangioma of the colon diagnosed by colonoscopy. J Pediatr Surg 1976:11:83–4

    Article  CAS  PubMed  Google Scholar 

  58. Demling L, Classen M, Frühmorgen P. Atlas of enteroscopy. Heidelberg: Springer-Verlag, 1975:162–63, 214–15.

    Google Scholar 

  59. Harned RK, Dobry CA, Farley GE. Cavernous hemangioma of the rectum and appendix. Dis Colon Rectum 1974;17:759–62

    CAS  PubMed  Google Scholar 

  60. Bailey JJ, Barrick CW, Jenkinson EL. Hemangioma of colon. JAMA 1956;160:658–60

    CAS  Google Scholar 

  61. Grieco RV, Bartone NF. Roentgen visualization of phleboliths in hemangioma of the gastrointestinal tract. AJR 1967;101:406–8

    Google Scholar 

  62. Flannery MG, Caster MP. Hemangioma of stomach with roentgenologic diagnostic point. AJR 1957;77:38–9

    Google Scholar 

  63. Margulis AR, Selected cases. Gastrointest Radiol 1981;6:363–4

    Article  CAS  PubMed  Google Scholar 

  64. Clark RA, Rosch J. Arteriography in the diagnosis of large bowel bleeding. Radiology 1970;94:83–6

    CAS  PubMed  Google Scholar 

  65. Baum S, Stein GN, Nusbaum M, Chait A. Selective arteriography in the diagnosis of hemorrhage in the gastrointestinal tract. Radiol Clin North Am 1969;7:131–45

    CAS  PubMed  Google Scholar 

  66. Kasabach HH, Merritt KK. Capillary hemangioma with extensive purpura. Am J Dis Child 1940;59:1063–70

    Google Scholar 

  67. Shim WKT. Hemangiomas of infancy complicated by thrombocytopenia. Am J Surg 1968;116:896–906

    Article  CAS  PubMed  Google Scholar 

  68. Hill JH, Longino LA. Giant hemangioma with thrombocytopenia. Surg Gynecol Obstet 1962;114:304–12

    PubMed  Google Scholar 

  69. Blix S, Aas K. Giant hemangioma, thrombocytopenia, fibrinogenopenia, and fibrinolytic activity. Acta Med Scand 1961;169:63–70.

    Article  Google Scholar 

  70. Silver H, Aggeler K, Crane JT. Hemangioma (capillary and cavernous) with thrombopenic purpura. Am J Dis Child 1948;76:513–20

    PubMed  CAS  Google Scholar 

  71. Weissman J, Tagnon HJ. Syndrome of hemangioma and thrombocytopenic purpura in infants. Arch Intern Med 1953;92:523–6

    Google Scholar 

  72. Huysinga JK, Minder WH. Hemangiomatosis and thrombocytopenia. Arch Chir Neerl 1957;9:193–9

    CAS  PubMed  Google Scholar 

  73. Good TA, Carnazzo SF, Good RA. Thrombocytopenia and giant hemangioma in infants. Am J Dis Child 1955;90:260–74

    CAS  Google Scholar 

  74. Stuber HB. Das syndrom Hämangiom, thrombopenische purpura und anämie im Säuglingsalter. Helv Paediatr Acta 1956;11:194–207.

    CAS  PubMed  Google Scholar 

  75. Blix S. Effect of fibrinogen, blood transfusion and epsilon-aminocaproic acid in two patients with fibrinolytic activity. Acta Med Scand 1961;169:71–8

    Article  Google Scholar 

  76. Brizel HE, Raccuglia G. Giant hemangioma with thrombocytopenia, radio-isotopic demonstration of platelet sequestration. Blood 1965;26:751–6

    CAS  PubMed  Google Scholar 

  77. Kontras SB, Green OC, King L, Duran RJ. Giant hemangioma with thrombocytopenia—case report with survival and sequestration studies of platelets labeled with chromium 51. Am J Dis Child 1963;105:188–95

    CAS  PubMed  Google Scholar 

  78. Inceman S, Tangun Y. Chronic defibrination syndrome due to a giant hemangioma associated with microangiopathic hemolytic anemia. Am J Med 1969;46:997–1002.

    Article  CAS  PubMed  Google Scholar 

  79. Propp RP, Scharfman WB. Hemangioma-thrombocytopenia syndrome associated with microangiopathic hemolytic anemia. Blood 1966;28:623–33

    CAS  PubMed  Google Scholar 

  80. Beller FK, Ruhrmann G. Zur pathogenese des Kasabach-Merritt Syndromes. Klin Wochenschr 1959;37:1078–82

    Article  CAS  PubMed  Google Scholar 

  81. Verstraete M, Vermylen C, Vermylen J, Vandenbroucke J. Excessive consumption of blood coagulation components as cause of hemorrhagic diathesis. Am J Med 1965;38:899–908

    Article  CAS  PubMed  Google Scholar 

  82. Verstraete M, Amery A, Vermylen C, Robyn G. Heparin treatment of bleeding following intravascular coagulation. Lancet 1963;1:446

    Article  CAS  PubMed  Google Scholar 

  83. Rodriguez-Erdmann F, Button L, Murray JE, Moloney WC Kasabach-Merritt syndrome—coagulo-analytical observations. Am J Med Sci 1971;261:9–15.

    Article  CAS  PubMed  Google Scholar 

  84. Hillman RS, Phillips LL. Clotting-fibrinolysis in a cavernous hemangioma. Am J Dis Child 1967;113:649–53

    CAS  PubMed  Google Scholar 

  85. Fineberg C, Weiss A. Surgical management of cavernous hemangioma of the chest wall—relationship of associated coagulation defects to this lesion. JAMA 1963;185:252–5

    Google Scholar 

  86. Schanberge JN, Tanaka K, Gruhl MC. Chronic consumption coagulopathy due to hemangiomatous transformation of the spleen. Am J Clin Pathol 1971;56:723–9

    Google Scholar 

  87. Wallerstein RG. Spontaneous involution of giant hemangioma. Am J Dis Child 1961;102:233–5

    CAS  PubMed  Google Scholar 

  88. Eadie DGA. Cavernous hemangioma of the descending colon. Br J Surg 1958;46:223–6

    CAS  PubMed  Google Scholar 

  89. Schenk HL. Diffuse cavernous hemangioma of the rectum and rectosigmoid. California Med 1957;87:111–6

    CAS  PubMed  Google Scholar 

  90. Hasegawa K, Lee W-Y, Noguchi T, Yaguchi T, Sasaki H, Nagasako K. Colonoscopic removal of hemangiomas. Dis Colon Rectum 1981;24:85–9

    CAS  PubMed  Google Scholar 

  91. Scott WMcC, Brand NE. Giant hemangioma of the rectum. Br J Surg 1957;45:294–9

    CAS  PubMed  Google Scholar 

  92. Buie LA, Nesselrod JP. Diffuse cavernous hemangioma of the rectum. Surgery 1938;3:379–85

    Google Scholar 

  93. Oppenheim A, O'Brien JP. Unusual anal, rectal and perirectal tumors palpable by rectal examination. Am J Surg 1950;79:302–11

    Article  CAS  PubMed  Google Scholar 

  94. Williams OK, vanBuskirk OK, Burns FW, Mellish RWP. Giant hemangioendothelioma with thrombocytopenia and hypofibrinogenemia. AJR 1969;106:204–10

    CAS  Google Scholar 

  95. Chaimoff Ch, Lurie H. Hemangioma of the rectum—clinical appearance and treatment. Dis Colon Rectum 1978;21:295–6

    CAS  PubMed  Google Scholar 

  96. Gabriel WB. The principles and practice of rectal surger. Spring-field: Charles C. Thomas, 1963:116–18

    Google Scholar 

  97. Fost NC, Esterly NB. Successful treatment of juvenile hemangiomas with prednisone. J Pediatr 1968;72:351–7

    Article  CAS  PubMed  Google Scholar 

  98. Edgerton MT. The treatment of hemangiomas—with special reference to the role of steroid therapy. Ann Surg 1976;183:517–32.

    Article  CAS  PubMed  Google Scholar 

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Lyon, D.T., Mantia, A.G. Large-bowel hemangiomas. Dis Colon Rectum 27, 404–414 (1984). https://doi.org/10.1007/BF02553013

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