Case Report: Ileal Pouch-Anal Anastomosis for Diffuse Benign Cavernous Vascular Malformation

Purpose: To describe and characterize a rare case of pan-colonic diffuse benign cavernous vascular malformation. Methods: This is a single case report with intraoperative figures, pathologic and histologic evaluation, and review of treatment decision making for a rarely described pan-colonic benign cavernous vascular malformation. Results: A 34-year-old male with a history of recurrent gastrointestinal bleeds starting early in life presented for evaluation. He was found to have multiple vascular proliferations in his rectosigmoid, cecum, liver, and small bowel mesentery on axial imaging and endoscopic evaluation. He underwent total proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pathologic analysis of the vascular proliferations was consistent with diffuse benign cavernous malformations. The patient recovered well postoperatively. Conclusion: We present the first case known of total proctocolectomy with IPAA for diffuse benign cavernous vascular malformation. This is a safe treatment approach recommended for patients with pan-colonic vascular lesions. Gastroenterologists and colorectal surgeons should be familiar with this condition due to high morbidity and unique treatment algorithms.