P3087 - A Rare Presentation of Painless Rectal Bleeding With Dextrocardia and Phleboliths

Maria F. Kewish, MD, Sahar Baloch, MD, Bhoomi Shah, MD
Southeasthealth, Dothan, AL

Introduction: Colorectal hemangiomas are rare but often misdiagnosed as a cause of GI bleeding. Patients with colorectal hemangiomas usually have a clinical triad of recurrent episodes of painless rectal bleeding, multiple ectopic phleboliths, and cutaneous hemangioma

Case Description/Methods: A 34-year-old African American male with a medical history of dextrocardia, hemorrhoids, ulcerative proctitis presented with complaints of syncope. Reported chronic rectal bleeding along with melena and hematochezia. Pertinent labs showed Hb/Hct of 7.4/24.3, and D-dimer of 767. CT of the chest, abdomen and pelvis revealed calcifications in the spleen and a small hemangioma or cyst in the liver.He was transfused with 1 PRBC, and GI was consulted. GI concluded that this presentation could be suggestive of ulcerative colitis, and findings suspicious for hemangiomatosis, which can be seen with dextrocardia. Colonoscopy showed normal colon, with the exception of the rectum from the anal verge and findings were suggestive of rectal cavernous hemangiomatosis. Case was discussed with radiology, who agreed with the same diagnosis.

Discussion: Our case is interesting as hemangiomatosis is a rare diagnosis of rectal bleeding. Patient also had findings of phleboliths, which are associated with this condition. These tumors are important to diagnose, otherwise they can lead to massive hemorrhage. If a patient presents with a triad of intermittent hematochezia, multiple phleboliths and cutaneous hemangiomas this diagnosis should be considered



Disclosures:


Maria F. Kewish, MD, Sahar Baloch, MD, Bhoomi Shah, MD. P3087 - A Rare Presentation of Painless Rectal Bleeding With Dextrocardia and Phleboliths, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.