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Multiple venous malformations in the left colon and rectum: a long-standing case managed conservatively and an update of current literature
  1. Sashiananthan Ganesananthan1,
  2. Jonathan Barlow2,
  3. Dharmaraj Durai2 and
  4. Antony Barney Hawthorne2
  1. 1 School of Medicine, Cardiff University, Cardiff, UK
  2. 2 Gastroenterology, University Hospital of Wales, Cardiff, UK
  1. Correspondence to Sashiananthan Ganesananthan, GanesananthanS{at}


Venous or cavernous malformations of the colon or rectum are a rare cause of lower gastrointestinal bleeds. It has been previously described as a diffuse cavernous haemangioma which was thought to be a benign vascular tumour. It mainly affects the rectosigmoid area of the gastrointestinal tract and is most common in children and young adults. Misdiagnosis is common with patients averaging a total of 19 years delay to this final diagnosis. We report a case of a 65-year-old patient who presented with occult, painless rectal bleeding and prior to this presentation, had been managed variously as colitis and angiodysplasia. This article aims to delineate the updated classification of this disease, principal clinical clues to aid the diagnosis while discussing patient treatment options and potential challenges faced in patient management.

  • GI bleeding
  • inflammatory bowel disease
  • endoscopy
  • venous malformations

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  • Contributors SG was involved with the writing and editing of this manuscript. JB was involved with the initial editing and review of the manuscript. DD was involved in patient care and reviewing the final piece. ABH was involved with editing, reviewing and also involved with obtaining patient consent and endoscopic images for which he performed.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.