Eur J Pediatr Surg 2020; 30(05): 406-412
DOI: 10.1055/s-0040-1716727
Review Article

Colorectal Vascular Anomalies

Anna McGuire
1   Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
,
Belinda H. Dickie
2   Department of Pediatric Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
› Author Affiliations

Abstract

Vascular anomalies represent a diverse group of tumors and malformations. Those involving the colon and rectum can greatly impact patients' quality of life. Proper workup to ensure the correct diagnosis can vary and may include endoscopic and radiographic studies. These lesions can also be challenging to treat and often require a multidisciplinary approach to ensure the best possible outcome. Treatment can include medical therapy, sclerotherapy, endoscopic, and operative intervention. Many patients will require multimodal therapy. We discuss the workup and management of vascular lesions of the colon and rectum.



Publication History

Received: 06 August 2020

Accepted: 16 August 2020

Article published online:
17 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 
  • References

  • 1 Dasgupta R, Fishman SJ. ISSVA classification. Semin Pediatr Surg 2014; 23 (04) 158-161
  • 2 Soukoulis IW, Liang MG, Fox VL, Mulliken JB, Alomari AI, Fishman SJ. Gastrointestinal infantile hemangioma: presentation and management. J Pediatr Gastroenterol Nutr 2015; 61 (04) 415-420
  • 3 Boscolo E, Limaye N, Huang L. , et al. Rapamycin improves TIE2-mutated venous malformation in murine model and human subjects. J Clin Invest 2015; 125 (09) 3491-3504
  • 4 Kulungowski AM, Fox VL, Burrows PE, Alomari AI, Fishman SJ. Portomesenteric venous thrombosis associated with rectal venous malformations. J Pediatr Surg 2010; 45 (06) 1221-1227
  • 5 Sood M, John P, Booth IW. Clinical quiz. Extensive low-flow venous malformations of the rectum and distal colon. J Pediatr Gastroenterol Nutr 2000; 31 (03) 326-330
  • 6 Moore JD, Thompson NW, Appelman HD, Foley D. Arteriovenous malformations of the gastrointestinal tract. Arch Surg 1976; 111 (04) 381-389
  • 7 Kido M, Nakamura K, Kuwahara T. , et al. Arteriovenous malformation that caused prolapse of the colon and was treated surgically in an infant: a case report. Surg Case Rep 2020; 6 (01) 67-5
  • 8 Kulkarni SG, Dhawan PS, Shah SS. , et al. Type 2 arteriovenous malformation of the sigmoid colon with unusual angiographic and characteristic histologic appearances. Endoscopy 2008; 30 (06) S75-S76
  • 9 Pierce J, Matthews J, Stanley P, Panossian A, Ford H, Anselmo D. Perirectal arteriovenous malformation treated by angioembolization and low anterior resection. J Pediatr Surg 2010; 45 (07) 1542-1545
  • 10 Defreyne L, Meersschaut V, van Damme S, Berrevoet F, Robberecht E, Praet M. Colonic arteriovenous malformation in a child misinterpreted as an idiopathic colonic varicosis on angiography: remarks on current classification of childhood intestinal vascular malformations. Eur Radiol 2003; 13 (Suppl. 04) L138-L141
  • 11 Kumar S. Colonic Dieulafoy's lesion. Gastrointest Endosc 2015; 81 (03) 761
  • 12 Chuang FJ, Lin JS, Yeung CY, Chan WT, Jiang CB, Lee HC. Intestinal angiodysplasia: an uncommon cause of gastrointestinal bleeding in children. Pediatr Neonatol 2011; 52 (04) 214-218
  • 13 Sriram G, Zendejas B, Vargas SO, Chen C. Colonic mesenteric lymphatic malformation presenting as an intraabdominal abscess in an infant: A case report. Int J Surg Case Rep 2017; 39: 154-158
  • 14 Rajebi MR, Alomari AI. The misguided research on Klippel-Trenaunay syndrome. Plast Reconstr Surg 2011; 128 (05) 565e-566e
  • 15 Bloom J, Upton III J. CLOVES syndrome. J Hand Surg Am 2013; 38 (12) 2508-2512
  • 16 McGuire A, Dickie B, Fox V, Fishman S. Rectal sclerotherapy for management of hematochezia and prolapse. Poster presented at: ISSVA Workshop 2020; May 14–15, 2020; Virtual Conference
  • 17 Adams DM, Trenor III CC, Hammill AM. , et al. Efficacy and safety of sirolimus in the treatment of complicated vascular anomalies. Pediatrics 2016; 137 (02) e20153257-e20153257
  • 18 Lehnert T, Boehm R, Mayer S, Sorge I, Richter T, Till H. Laparoscopic resection of a colonic venous malformation in an infant. CRSLS: MIS Case Reports SLS 2014; 18: 2014-12
  • 19 Soblet J, Kangas J, Nätynki M. , et al. Blue rubber bleb nevus (BRBN) syndrome is caused by somatic TEK (TIE2) mutations. J Invest Dermatol 2017; 137 (01) 207-216
  • 20 Fishman SJ, Smithers CJ, Folkman J. , et al. Blue rubber bleb nevus syndrome: surgical eradication of gastrointestinal bleeding. Ann Surg 2005; 241 (03) 523-528
  • 21 Deshpande GA, Samarasam I, George SV, Chandran S. Blue rubber bleb nevus syndrome: a rare cause of chronic gastrointestinal bleed in adults. Singapore Med J 2014; 55 (11) e175-e176
  • 22 Lybecker MB, Stawowy M, Clausen N. Blue rubber bleb naevus syndrome: a rare cause of chronic occult blood loss and iron deficiency anaemia. BMJ Case Rep 2016; 2016: Bcr2016216963
  • 23 Maluenda C, Bodas A, Pérez-Segura P, Pazos A, Fernandez S, Asteinza M. Blue rubber bleb nevus diagnosed by wireless capsule endoscopy. J Paediatr Child Health 2010; 46 (1-2): 68-69
  • 24 Yuksekkaya H, Ozbek O, Keser M, Toy H. Blue rubber bleb nevus syndrome: successful treatment with sirolimus. Pediatrics 2012; 129 (04) e1080-e1084
  • 25 Cardoso H, Dias JA, Silva M. , et al. Education and imaging. Gastrointestinal: successful treatment with sirolimus of a patient with blue rubber bleb nevus syndrome. J Gastroenterol Hepatol 2016; 31 (03) 519
  • 26 Salloum R, Fox CE, Alvarez-Allende CR. , et al. Response of blue rubber bleb nevus syndrome to sirolimus treatment. Pediatr Blood Cancer 2016; 63 (11) 1911-1914
  • 27 Prasad V, Fishman SJ, Mulliken JB. , et al. Cutaneovisceral angiomatosis with thrombocytopenia. Pediatr Dev Pathol 2005; 8 (04) 407-419
  • 28 Lanöel A, Torres Huamani AN, Feliú A, Sala MJ, Alvarez M, Cervini AB. Multifocal lymphangioendotheliomatosis with thrombocytopenia: presentation of two cases treated with sirolimus. Pediatr Dermatol 2016; 33 (04) e235-e239
  • 29 Smith AR, Hennessy JM, Kurth MA, Nelson SC. Reversible skeletal changes after treatment with bevacizumab in a child with cutaneovisceral angiomatosis with thrombocytopenia syndrome. Pediatr Blood Cancer 2008; 51 (03) 418-420
  • 30 Kline RM, Buck LM. Bevacizumab treatment in multifocal lymphangioendotheliomatosis with thrombocytopenia. Pediatr Blood Cancer 2009; 52 (04) 534-536
  • 31 Noel RJ, Duffy KJ, Kelly ME, Tondravi N, North PE, Drolet BA. Endoscopic management of gastrointestinal bleeding from multifocal lymphangioendotheliomatosis with thrombocytopenia: limited efficacy and complications. J Pediatr Gastroenterol Nutr 2012; 54 (06) 822-824