Giant vascular malformation of the right colic flexure as a cause of abdominal pain

Abstract

A 31-year-old man admitted to clinic with complains of occasional pains in the right upper quadrant unrelated to the food. Results of laboratory tests were in the normal range. There were wall thickening of the ascending colon with sites of calcification located intramural according to abdominal contrast-enhanced multislice computed tomography. The above-mentioned structures accumulated contrast during a venous phase of computed tomography. A barium X-ray was performed, filling defects in right colon were detected but barium follow throughs was normal. Multiple dilated vascular structures of variable sizes l affecting the bowel submucosa in ascending colon for more than 10 cm were detected during the colonoscopy. The patient was diagnosed with hemangiomatosis of colon. Because of the high risk of massive large-bowel hemorrhage and malignization the laparoscopic right hemicolectomy was performed. Morfologic findings were interpreted as vascular malformation of colon. The patient has been activated fully on 1-st day after surgery, discharged on 5-th day in hospital. Gastrointestinal (GI) vascular malformation is an infrequent disorder of blood vessel formation characterized by existence of tumor-like vascular structures through the entire GI tract. Nowadays there is no single approach to the management of this group of diseases. Surgery is the only radical metod of the treatment of vascular malformation. The laparoscopic approach has substantional advantages in treatment of this infrequent group of diseases.