Letter to the Editor: Vascular Malformations in Colorectal Surgery – An Uncommon and Potentially Fatal Condition

Cavernous vascular malformations, while benign and rare can lead to significant morbidity, including chronic pain and bleeding. Mortality associated with massive gastrointestinal bleeding can be as high as 50%, therefore the management of these conditions in non-emergency setting is preferable. Interestingly, there are a number of syndromes that are associated with these lesions such as Osler-Weber Rendu syndrome, Proteus Syndrome, Kasabach-Merritt syndrome and Klippel-Trenaunay-Weber syndrome but only approximately 2% have gastrointestinal manifestations. Vascular malformations are usually seen at the rectosigmoid level, while colonic localization is very uncommon. The extension of the lesions and its morphology should be assessed by several diagnostic modalities which include colonoscopy, CT with contrast enhancement and other test such as capsule endoscopy, MRI etc. The case report of “Ileal Pouch-Anal Anastomosis for Diffuse Benign Cavernous Vascular Malformation” demonstrates a successful application of ileal pouch-anal anastomosis in a patient with diffuse benign cavernous vascular malformation expanding the indication for these procedures.