Abstracts
1999 Digestive Disease Week

# 2094 DIFFUSE CAVERNOUS HEMANGIOMAS AND GIANT ARTERIOVENOUS MALFORMATIONS OF THE RECTUM: PROCTECTOMY WITH COLOANAL ANASTOMOSIS IS SAFE AND EFFECTIVE
Harry L Reynolds, Univ Hosp of Cleveland, Case Western Reserve Univ, Cleveland, OH; I C Lavery, Cleveland Clin and Univ Hosp of Cleveland, Cleveland, OH; Victor W Fazio, Cleveland Clin Fdn, Cleveland, OH

Purpose: Our experience with rare diffuse rectal hemangiomas(DH) or arteriovenous malformations(AVM) was examined to evaluate surgical results. Methods: A review of all patients with DH or AVM treated from 1984 to 1995. Results: Nine patients were treated. Eight presented with bleeding (mean preop transfusion requirement 6 units (0-34)) and 1 with tenesmus and diarrhea. All were diagnosed on endoscopic examination. Treatment consisted of anterior proctosigmoidectomy and coloanal anastomosis in 7 with lesions limited to the rectosigmoid. Total proctocolectomy and ileal pouch anal anastomosis was performed in 1 with a synchronous cecal hemangioma. Sclerotherapy was performed in 1 patient with Klippel-Trenaunay syndrome whose lesion was unresectable because of extrapelvic extension on MRI. Pathologic exam revealed 6 DHs, and 2 AVMs. Operative blood loss averaged 700cc's (200-1400) with a mean operative transfusion requirement of 1 unit (0-4). Complications consisted of an anastomotic leak (1), a partial small bowel obstruction (1), and impotence (1). No post operative hematochezia has occurred (mean follow-up of 41 months (1-122)). Conclusions: Surgical resection is safe and effective with rectal DH or AVM.

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