Publication:

Laparoscopic resection for rectal arteriovenous malformation: a case report

Arteriovenous malformation (AVM) is a vascular anomaly characterized by direct communication between arteries and veins without intervening capillaries. A 67-year-old man with no history of surgery, trauma, or gastrointestinal bleeding was incidentally found to have a rectal AVM during follow-up imaging after endoscopic resection of a rectal neuroendocrine tumour. Contrast-enhanced computed tomography revealed multiple dilated veins surrounding the rectum and sigmoid colon, with shunting from the inferior mesenteric artery into a dilated venous sac and subsequent drainage into the inferior mesenteric vein. Colonoscopy identified a bulbous, dilated vascular proliferation 15–25 cm from the anal verge. Treatment was considered necessary due to the potential for future rupture. Interventional radiology was deemed unsuitable because of the extensive nature of the lesion, and the patient underwent laparoscopic low anterior resection with early ligation of the inferior mesenteric artery and vein. The postoperative course was uneventful, discharged on postoperative day eight.