DOI: http://dx.doi.org/10.18203/2349-2902.isj20193363

Young adult with varicosities and recurrent lower gastrointestinal bleeding

Vidhyachandra V. Gandhi, Pratik Gautam, Nitin V. Pai, Sujai Hegde

Abstract


A 30 years gentleman presented with anaemia since last ten years due to recurrent rectal bleeding. He has had multiple admissions with transfusions in the preceding 10 years without a clear clinical diagnosis. His physical examination revealed gross pallor, prominent veins on the lateral side of the left lower limb with minimal hypertrophy and a hemangiomatous patch over the left buttock. Colonoscopy revealed a few dilated tortuous submucosal vessels in the rectum and sigmoid colon. A MR angiogram showed absent left popliteal vein and angiomatous lesions in the rectum and sigmoid colon. He was diagnosed to have Klippel-Trenaunay syndrome with hemangiomata of the lower gastrointestinal tract causing bleeding. He underwent a low anterior resection with stapled anastomosis, which has effectively controlled his bleeding. Adults with gastrointestinal bleeding due to congenital venous malformations commonly have visible external stigmata, which are often pointers of rare syndromes.


Keywords


Klippel-Trenaunay syndrome, Lower gastrointestinal bleeding

Full Text:

PDF

References


Servelle M. Klippel and Traunaunay Syndrome. 768 operated cases. Ann Surg. 2001: 365–373.

Servelle M, Bastin R, Laygue J et al. Haematuria and rectal bleeding in the child with Klippel and Traunaunay Syndrome. Ann Surg. 1976;183:413-28.

Azizkhan RG. Life threatening haematochezia from a recto sigmoid vascular malformation in Klippel Traunaunay syndrome: Long term palliation using an argon laser. J Pediatric Surg. 1991;26:1125-8.

Jacob AG, Driseoll DJ, Shanghnessy WJ, Stanson AW, Clay RP, Gloviczki P. Klippel Trenaunay Syndrome. Spectrum and Management. Mayo Clin Proc. 1998;73:28-36.

Ghahremani GG, Kangartoe H, Valbery F, Meyers MA. Diffuse cavernous haemangioma of the colon in the Klippel Traunaunay Syndrome. Radiology. 1976;118:673-8.

Haber M, Reuben A, Burrell M, Oliverio P, Salem RR, West AB. Multiple focal nodular hyperplasia of the liver associated with hemi hypertrophy and vascular malformations. Gastroenterology. 1995;108:1256-62.