A Case of Diffuse Vascular Ectasia of the Left Colon

Seiji Miura, Akihisa Nemoto, Hisayasu Aoki, Yutaka Satoi, Kenjiro Amino, Yoshitsugu Takeda, Kanji Mieno, Jun-ichi Shikata

First Department of Surgery, Teikyo University School of Medicine

A case of diffuse vascular ectasia of the left colon is reported. A 52-year-old woman was admitted to our hospital because of passing dark red blood by rectum. She had had two other episodes of gross rectal bleeding. Colonoscopic examination clearly showed bleeding, small erosions in the descending colon and non-bleeding diverticula in the sigmoid colon. A barium enema examination was performed three days later and showed longitudinal ulcer scars in the descending colon. Microscopically the biopsied specimen suggested vascular leiomyoma, but inferior mesenteric arteriography and abdominal computed tomography did not reveal tumors or vascular lesions. In view of the long history and histological findings it was decided to resect the descending and signoid colon. Histological examination of the resected specimen showed proliferation of the dilated, tortuous vessels associated with increased collagenous fibers in the submucosal layers. The anomaly expanded the submucosa involving almost the entire length of the resected colon. Vascular ectasia of the colon is usually a localized lesion ocurring mainly in the right colon, but multiple lesions and lesions of the left colon have been reported. Baum et al. postulated that vascular ectasia is an acquired and age-related change in the colonic vasculature caused by ischemia. The present case might imply an increase in the incidence of colonic vascular ectasias among Japanese people.

Key words
arteriovenous malformation, colon

Reprint requests
Seiji Miura First Department of Surgery, Teikyo University School of Medicine
2-11-1 Kaga, Itabashi-ku, Tokyo, 173 JAPAN

Accepted
May 9, 1990

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