Lege Artis Medicinae

[Resection of colonic polypoid cavernous hemangioma with help of rubber rings]

ÁCSNÉ Tóth Andrea1, LUKOVICH Péter1, LAKATOS Péter László2, KARDOS Magdolna3, ARANY Andrea Szilvia4, HARSÁNYI László1

MARCH 20, 2014

Lege Artis Medicinae - 2014;24(03)

[INTRODUCTION - Cavernous hemangioma is a benign, rare disorder, usually localized in the distal part of the gastrointestinal system. CASE REPORT - In a 19-year-old woman treated for Crohn’s disease localized to the colon, a polypoid lesion was found during routine colonoscopy. The lesion appeared to be vascularized, purple in color and could be localized 25 cm above the anal sphincter. MSCT examination confirmed vascularization of the lesion. Considering the high risk for severe bleeding, resection was performed with surgical assistance. At first, two rubber rings were placed around the polypoid lesion. Thereafter 1 ml of epinephrine was injected into the neck of the lesion above the rubber rings, followed by polypectomy with a standard hook. No complications were present during the observation period. Histological examination of the polypoid lesion confirmed it to be cavernous hemangioma. CONCLUSION - On the basis of previous cases and the present case there might be a connection between inflammatory bowel disease and the development of cavernous hemangioma. We have not found any previous reports of a similar application of rubber rings. However, in cases where the risk of bleeding is high, this method is safe and easy to apply.]


  1. Semmelweis Egyetem, I. Sz. Sebészeti Klinika
  2. Semmelweis Egyetem, I. Sz. Belgyógyászati Klinika
  3. Semmelweis Egyetem, II. Sz. Patológiai Intézet
  4. Egyesített Szent István és Szent László Kórház-Rendelôintézet, Központi Radiológia



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Lege Artis Medicinae



[INTRODUCTION - Submucous lipomas are rare tumors of the colon and may be misdiagnosed as cancer because of their exophytic, polypoid growth and threatening bowel obstruction. CASE REPORT - A protruding, ulcerated and firm tumor preventing the investigation of the coecum was found by endoscopy in the ascending colon of a 50-year-old woman, who was subsequently operated on. The preoperative biopsy revealed only necrotic debris. Right hemicolectomy was performed because of threatening bowel obstruction and the presumed diagnosis of cancer. The tumor proved to be a 4 cm-large pedunculated submucosal lipoma. CONCLUSION - Despite recent diagnostic developments and the availability of better tools for the preoperative diagnosis of colonic lipomas, these tumors may still be misdiagnosed as carcinomas. Several circumstances contradict malignant dignity, such as: the relative circumscription of the mass, the trophic and only partial ulceration of the surface which is covered by normal mucosal layer elsewhere. To avoid unnecessary radicality in treatment, colon tumors with an uncertain preoperative diagnosis should undergo further diagnostic steps in order to clarify their nature. This could allow a more optimal therapeutic planning.]