“Watermelon rectum” associated with multiple vascular ectasia in the colon - 22/08/11
Doi : 10.1016/j.gie.2007.02.034
Kuangi Fu, MD, PhD
Division of Gastrointestinal Endoscopy and Oncology National Cancer Center Hospital East, Kashiwa, Chiba, Japan, Department of Radiology, Dokkyo Medical University, Mibu, Shimotuga, Tochigi, Japan
Hiroaki Ikematsu, MD
Division of Gastrointestinal Endoscopy and Oncology National Cancer Center Hospital East, Kashiwa, Chiba, Japan
David Paul Hurlstone, MBChB, FRCP MD(Dist)
Department of Endoscopy, Royal Hallamshire Hospital, Sheffield, UK
Yasushi Kaji, MD, PhD
Department of Radiology, Dokkyo Medical University, Mibu, Shimotuga, Tochigi, Japan
Tsutomu Ishikawa, MD, PhD
Department of Radiology, Dokkyo Medical University, Mibu, Shimotuga, Tochigi, Japan
Shigeaki Yoshida, MD
Division of Gastrointestinal Endoscopy and Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| Commentary This is a beautifully documented case … but of what? This vascular pattern does not suggest an underlying systemic disorder such as hereditary hemorrhagic telangiectasia, a syndrome such as Klippel-Trenaunay, a congenital lesion such as an arteriovenous malformation, or an acquired process such as angioectasia. It is somewhat redolent of portal hypertension, but an equally attractive alternative is that it represents an idiopathic process of which we do not know the etiology and for which we have no information on the anatomic and histologic structure. Absent a complete history and physical examination, a panintestinal mucosal inspection, a study of the vascular system, and a generous tissue sample that contains the lesion, we are in the position of making diagnoses by pattern recognition. But even the patterns of watermelons vary among the different varieties, eg, Orangeglo, Moon and Stars, Cream of Saskatchewan, and Melitopolski. As for treatment, I agree that observation is best, especially because the patient is asymptomatic. Finally, let us not forget genetic counseling, if appropriate. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2007
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 66 - N° 3
P. 601-602 - septembre 2007 Retour au numéro
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