Intestinal arteriovenous malformations: a diagnostic and therapeutic challenge
DOI:
https://doi.org/10.18203/2349-2902.isj20222240Keywords:
Arteriovenous malformation, Gastrointestinal hemorrhage, Diarrhea, ManagementAbstract
Arteriovenous malformations (AVM) of the intestine are rare causes of gastrointestinal bleeding. Diagnosis depends upon accurate interpretation of imaging features and histopathology to differentiate them from other vascular malformations. Presentation of colonic AVM with mucous diarrhea and pain is rare and poses diagnostic challenges. Usually, patients presenting with bleed need surgical intervention. The current report discussed one patient with chronic liver disease, extrahepatic portal vein thrombosis with small bowel AVM and two patients with colonic AVM, highlighting management strategies adopted.
References
Holleran G, Hall B, O'Regan M. Expression of Angiogenic Factors in Patients with Sporadic Small Bowel Angiodysplasia. J Clin Gastroenterol. 2015;49:831.
Danesh BJ, Spiliadis C, Williams CB, Zambartas CM. Angiodysplasia-an uncommon cause of colonic bleeding: colonoscopic evaluation of 1,050 patients with rectal bleeding and anaemia. Int J Colorectal Dis. 1987;2:218.
Naoki O, Tomonori Y, Hironori Y, Daigo A, Masanao N, Wataru H et al. Diagnosis and treatment of obscure GI bleeding at double balloon endoscopy. Gastrointestinal Endoscopy. 2007;66(3):S72-7.
Chung CS, Chen KC, Chou YH, Chen KH. Emergent single-balloon enteroscopy for overt bleeding of small intestinal vascular malformation. World J Gastroenterol. 2018;24:157-60.
Sakai E, Ohata K, Nakajima A, Matsuhashi N. Diagnosis and therapeutic strategies for small bowel vascular lesions. World J Gastroenterol. 2019;25(22):2720-33.
So M, Itatani Y, Obama K, Tsunoda S, Hisamori S, Hashimoto K, Sakai Y. Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization. Surg Case Rep. 2018;4:78.
Strate LL, Naumann CR. The role of colonoscopy and radiological procedures in the management of acute lower intestinal bleeding. Clin Gastroenterol Hepatol. 2010;8:333-43.
Ueda J, Yoshida H, Mamada Y, Taniai N, Mizuguchi Y, Shimizu T et al. Successful emergency enterectomy for bleeding ileal varices in a patient with liver cirrhosis. J Nippon Med Sch. 2006;73:221-5.
Gorospe EC, Leggett CL, Sun G. Inferior mesenteric arteriovenous malformation: An unusual cause of ischemic colitis. Ann Gastroenterol. 2012;25:165.
Szilagyi A, Ghali MP. Pharmacological therapy of vascular malformations of the gastrointestinal tract. Can J Gastroenterol. 2006;20(3):171-8.
