Snapshot quiz 12/08a
Authors: Vijay R and Nikhil MP
This benign rectal lesion which presented with massive lower gastrointestinal bleeding necessitating emergency abdominoperineal resection is diffuse cavernous rectal haemangioma. A 40-year-old man presented with severe lower gastrointestinal bleeding. Colonoscopy revealed active bleeding with blood clots in the rectum. Computed tomography revealed clots and rectal wall thickening. As the bleeding failed to respond to conservative measures, he was consented for, and subjected to emergency abdominoperineal resection with end colostomy. Postoperatively he made an uneventful recovery. A preoperative diagnosis and elective presentation would have enabled a resection and coloanal anastomosis and spared the patient a colostomy.