Multiple venous malformations in the left colon and rectum: a long-standing case managed conservatively and an update of current literature

Early and accurate diagnosis and selection of appropriate treatment plans are crucial for patients with gastrointestinal hemangiomas

Gastrointestinal hemangioma (GIH) is clinically rare, accounting for 7%-10% of benign gastrointestinal tumors and 0.5% of systemic hemangiomas. GIH can occur as either solitary or multiple lesions, with gastrointestinal bleeding as a significant clinical manifestation. Understanding the clinical and endoscopic features of GIH is essential for improving diagnostic accuracy, particularly through endoscopy and selective arteriography, which are highly effective in diagnosing GIH and preventing misdiagnosis and inappropriate treatment. Upon confirmed diagnosis, it is essential to thoroughly evaluate the patient's condition to determine the most suitable treatment modality—whether surgical, endoscopic, or minimally invasive intervention. The minimally invasive interventional partial embolization therapy using polyvinyl alcohol particles, proposed and implemented by Pospisilova et al, has achieved excellent clinical outcomes. This approach reduces surgical trauma and the inherent risks of traditional surgical treatments.

Anorectal hemangioma, a rare cause of lower gastrointestinal bleeding, treated with selective embolization: A case report

BACKGROUND

Anorectal hemangioma is a rare and frequently misdiagnosed cause of lower gastrointestinal (GI) bleeding. Here, we present a minimally invasive therapy with selective embolization.

CASE SUMMARY

A 21-year-old male patient experienced painless rectal bleeding since childhood and was treated for ulcerative colitis. Diagnostic studies later revealed specific characteristics for vascular lesions-anorectal hemangiomas. The severity of rectal bleeding caused symptomatic anemia and possible surgical treatment was associated with a high risk of fecal incontinence. Here, we present selective embolization, a minimally invasive therapeutic approach that is proven as an alternative therapeutic method of choice. The patient significantly improved temporarily and had a small ischemic ulcer, which healed with a control colonoscopy and developed no stenosis.

CONCLUSION

Awareness of the clinical and radiological features of GI hemangiomas may help improve diagnostics and avoid inappropriate therapeutic procedures.

Endoscopic injection of lauromacrogol foam sclerotherapy for rectal cavernous hemangioma: A case report

RATIONALE

Rectal cavernous hemangioma is a rare, benign vascular disease that seldom causes lower gastrointestinal bleeding, characterized by a high rate of misdiagnosis and missed diagnoses. Surgical treatment is considered to be relatively effective; however, it is accompanied by certain employed in the treatment of superficial hemangioma, boasting the advantages of minimally invasive surgery, including safety, effectiveness, reduced trauma, and rapid recovery. However, there is a lack of literature regarding the application of foam sclerosing agents for gastrointestinal hemangiomas.

CASE CONCERNS

We present a case of a 60-year-old male who was admitted to our hospital with a history of recurrent hematochezia for >1 year and worsening symptoms for 1 week. The patient's medical history was unremarkable.

DIAGNOSES

Following colonoscopy, nuclear magnetic resonance imaging, computed tomography, and other examinations, the final diagnosis was rectal cavernous hemangioma.

INTERVENTIONS

Due to the patient's refusal of surgery, endoscopic foam sclerotherapy using a lauromacrogol injection was performed after obtaining informed consent from the patient and their relatives.

OUTCOMES

Post-sclerotherapy, hematochezia symptoms ceased, and no adverse reactions were observed. Two months later, colonoscopy and nuclear magnetic resonance imaging showed that the hemangioma had almost completely disappeared, with only a small amount of tumor remnants, yielding a satisfactory curative effect.

CONCLUSION

Our findings indicate that endoscopic injection of a lauromacrogol foam sclerosing agent is a safe, effective, and minimally invasive treatment option for gastrointestinal cavernous hemangiomas.

Giant rectal vascular malformation: a rare differential diagnosis in rectal bleeding

Investigations in a woman with prolonged symptoms of laxative-resistant constipation and recurrent rectal bleeding revealed a giant rectal vascular malformation. Colonoscopy and MRI were performed to rule out malignancy and determine differential diagnoses. Repeated tests were necessary due to inconclusive results. After a definite diagnosis, image-guided, transcutaneously administered sclerotherapy was used. The intervention and postoperative course were uneventful. A minimally invasive procedure relieved symptoms and improved quality of life.

Revisiting imaging features of rectosigmoid vascular malformation with emphasis on multiparametric MRI: a case report

Background

Gastrointestinal vascular malformations are rare benign vascular neoplasms of the gastrointestinal tract, with the rectosigmoid region being the most frequently involved site. Patients often manifest with recurrent, intermittent rectal bleeding, which might occasionally be life-threatening.

Case presentation

A 39-year-old man with a history of hemorrhoid operations twice was presented to our gastroenterology department with blood in the stool and abdominal pain. After the colonoscopy, multiparametric MRI, and CT examinations, robotic low anterior resection was performed with the diagnosis of rectosigmoid venous malformation. The histopathological examination confirmed the diagnosis.

Conclusion

Colonoscopy is the preferred method in diagnosing rectosigmoid vascular malformation, but wrong and delayed diagnoses are common. Thus, imaging modalities might add to colonoscopy in equivocal cases.

Small bowel racemose hemangioma complicated with obstruction and chronic anemia: A case report and review of literature

BACKGROUND

Gastrointestinal hemangiomas are rare benign tumors. According to the size of the affected vessels, hemangiomas are histologically classified into cavernous, capillary, or mixed-type tumors, with the cavernous type being the most common and racemose hemangiomas being very rare in the clinic. Melena of uncertain origin and anemia are the main clinical manifestations, and other presentations are rare. Due to the rarity of gastrointestinal hemangiomas and lack of specific manifestations and diagnostic methods, preoperative diagnoses are often delayed or incorrect.

CASE SUMMARY

We report a 5-year-old girl who presented with abdominal pain, nausea, and vomiting for a duration of 10 h. The laboratory studies showed prominent anemia. Computed tomography and contrast-enhanced computed tomography of the abdomen revealed a small bowel obstruction caused by a giant abdominal mass. Segmental resection of the ileal lesions was performed through surgery, and the final pathology results revealed a diagnosis of racemose hemangioma complicated by a small bowel obstruction and simultaneous chronic anemia.

CONCLUSION

The current report will increase the understanding of the diagnosis and treatment of gastrointestinal hemangiomas and provide a review of the related literature.

Butyric Acid Increases the Therapeutic Effect of EHLJ7 on Ulcerative Colitis by Inhibiting JAK2/STAT3/SOCS1 Signaling Pathway

Ulcerative colitis (UC) is a refractory chronic disease characterized by bloody diarrhea and mucosal or submucosal ulcers. There is an urgent need of new drugs for the treatment of ulcerative colitis. EHLJ7 is a quaternary coptisine derivative. Herein, we explored the therapeutic effect of EHLJ7 on dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) in mice. Results showed that EHLJ7 have good effects on DSS-induced colitis. EHLJ7 significantly improved symptoms induced by DSS including of weight loss, colon contracture, disease activity index (DAI), inflammatory infiltration, and so on. Furthermore, results showed that EHLJ7 could enhance short-chain fatty acids (SCFAs) production especially butyric acid, suggesting that EHLJ7 could improve the metabolic disorder of intestinal flora to a certain extent. Further study indicated that EHLJ7 could cooperate with butyrate to exert its anti-ulcerative colitis effect by inhibiting the activation of janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3)/suppressor of cytokine signaling 1 (SOCS1) pathway. Therefore, EHLJ7 has a potential to be developed as a candidate for the treatment of colitis.