P3108 - A Rare Case of Cystic Fibrosis With Colonic Hemangioma

Christopher Kasia, MD, Neena Mohan, MD
Temple University Hospital, Philadelphia, PA

Introduction: Cystic fibrosis (CF) is classically characterized by chronic pulmonary infection and inflammation, pancreatic exocrine insufficiency, and other complications related to impaired mucous hydration and clearance. However, there is an uncommon and often unrealized impact owing to its effect on the gastrointestinal tract. While fibrosing colopathy is a well-documented phenomenon, the presence of gastrointestinal cavernous hemangiomas, a rare gastrointestinal finding, has not been described. We report a case of a patient with cystic fibrosis presenting with colonic hemangioma.

Case Description/Methods: The patient is a 45-year-old African American male with history of cystic fibrosis complicated by chronic home oxygen use, pancreatic insufficiency, and alternating constipation and diarrhea. He presented to our tertiary care center for lung transplant evaluation, requiring endoscopic evaluation for iron deficiency anemia, intermittent rectal bleeding, and chronic abdominal pain. On upper endoscopy, findings were notable for patchy erythema with friability and erosions throughout the gastric antrum as well as multiple white plaques throughout the duodenal bulb. Biopsies were notable for chronic gastritis and duodenitis, respectively, without evidence of H.pylori, metaplasia, or dysplasia. Colonoscopy was notable for diffuse colonic wall thickening characterized by congested and friable mucosa (image 1) in addition to two polyps: 4mm descending colon polyp and 9mm sigmoid colon polyp (image 2) with inflammatory appearances. Biopsies of the colonic mucosa resulted in prolonged oozing. Due to the friability and bleeding, polypectomy was deferred and therefore only biopsy of the largest polyp was performed. Pathology from the biopsies of the colonic mucosa was reported as benign colonic mucosa, while the sigmoid polyp biopsy showed capillary hemangioma in the lamina propria.

Discussion: Colonic hemangiomas are rare vascular malformations, and their presentation is noted by acute, recurrent, or chronic rectal bleeding as well as anemia. The treatment of choice for symptomatic patients is resection and highlights the need for an accurate diagnosis. This is the first report of a patient with cystic fibrosis presenting with colonic hemangioma and highlights the need to be aware of uncommon gastrointestinal pathology arising in this patient population. Further research into abnormal colon pathology in cystic fibrosis patients would help determine the risk of bleeding and anemia.



Disclosures:


Christopher Kasia, MD, Neena Mohan, MD. P3108 - A Rare Case of Cystic Fibrosis With Colonic Hemangioma, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.