Visceral Vascular Anomalies

https://doi.org/10.1016/S1052-5157(18)30048-5Get rights and content

Gastrointestinal endoscopy is an essential modality often used for initial diagnostic assessment and staging of visceral vascular anomalies, especially when bleeding is the presenting symptom. Some lesions have a pathognomonic appearance on endoscopy. Others are less clearly indentifiable and require a multidisciplinary assessment, including histopathology, for a correct diagnosis. Proper application of nomenclature is crucial to prevent the institution of improper therapies. Advanced endoscopic methods, including endosonography and various hemostatic techniques, are useful to evaluate the depth and character of gastrointestinal wall involvement and to provide minimally invasive treatment when appropriate.

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Cited by (24)

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    VMs of the GI tract can have a pathognomonic appearance as bluish vascular convolutes when viewed via endoscopy, but are sometimes difficult to detect if only polypoid alterations are found macroscopically.6 Due to their complex manifestations, VMs require a multidisciplinary treatment approach.7,8 Therefore, endoscopy and radiologic imaging modalities, particularly magnetic resonance imaging (MRI), are often used to evaluate the extent and involvement of the GI wall, as well as to determine the flow characteristics and draining veins.9

  • Vascular Anomalies in Pediatrics

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    VMs of the GI tract can be solitary or multifocal and variably involve any or all layers of the bowel wall. A majority of GI VMs occur as transmural lesions of the left colon and rectum with variable local extension into pelvic structures [8,104,105]. GI VMs frequently present with lower GI bleeding.

  • Vascular Anomalies in Pediatrics

    2012, Surgical Clinics of North America
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    GI tract lesions may cause chronic bleeding and anemia.155 Bowel VMs may be present throughout but are more commonly found encompassing the entire left colon, rectum, and surrounding pelvic and retroperitoneal structures.3,102,156 A rectal VM associated with ectasia of mesenteric veins is a risk factor for portomesenteric venous thrombosis.157

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    2010, Journal of Pediatric Surgery
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    The mural architecture is distorted because of a paucity of and clumping of vascular smooth muscle cells as well as absent or incompetent valves that may be responsible for the progressive, gradual expansion of VMs with time. Rectal VMs variably involve the surrounding mesentery, retroperitoneum, pelvic space, muscles, bladder, vagina, subcutaneous tissues, as well as the mesenteric veins and portal trunk [3,7]. Unlike infantile hemangiomas, rectal VMs are not tumors and do not involute.

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