Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percu...

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Bibliographic Details
Published in:Case reports in gastroenterology 2021-01, Vol.15 (1), p.262-268
Main Authors: Hong, Jihoon, Lee, Sang Yub, Cha, Jung Guen, Heo, Jun
Format: Article
Language:English
Subjects:
anal pain
Anemia
arteriovenous malformation
Case reports
Colonoscopy
Edema
Embolization
Ethanol
Hypertension
Medical imaging
Pain
Polyvinyl alcohol
Rectum
Sclerotherapy
Single Case
tenesmus
Thrombosis
transarterial ethanol sclerotherapy
Veins & arteries
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Summary:Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percutaneous transarterial ethanol sclerotherapy. The patient underwent routine colonoscopy with biopsy at the time of visit; however, an accurate diagnosis was difficult. Subsequent contrast-enhanced computed tomography (CT) and angiography revealed a rectal AVM emerging from the distal inferior mesenteric artery with engorged superior rectal veins. The feeding artery was catheterized, and concurrent transarterial sclerotherapy with 80% ethanol was performed. There was no major complication related to the procedure. Disappearance of AVM nidus and improvement of associated venous congestion were shown by follow-up CT. There was no recurrence of symptoms after 10 months of clinical observation. Transarterial ethanol sclerotherapy is safe and effective in treating rectal AVM and can be considered as one of the nonsurgical treatment options.
ISSN:1662-0631
1662-0631
DOI:10.1159/000513147