Korean J Gastroenterol.  2011 Sep;58(3):157-161. 10.4166/kjg.2011.58.3.157.

Involvement of Splenic Hemangioma and Rectal Varices in a Patient with Klippel - Trenaunay Syndrome

Affiliations
  • 1Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. srjee@inje.ac.kr

Abstract

Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.

Keyword

Klippel-Trenaunay-Weber syndrome; Hemangioma; Varicose veins

MeSH Terms

Adult
Colonoscopy
Female
Hemangioma/*complications
Humans
Iron, Dietary/therapeutic use
Klippel-Trenaunay-Weber Syndrome/complications/*diagnosis/drug therapy
Rectum/blood supply
Spleen/blood supply
Tomography, X-Ray Computed
*Varicose Veins

Figure

  • Fig. 1. An abdominal CT scan revealed multiple hemangiomas in the spleen (A), and fusiform aneurysmal dilatation of the left common (B) and internal iliac veins (C).

  • Fig. 2. Colonoscopy showed hemangiomatous involvement in the rectum; there were rectal varices, but no evidence of active bleeding.

  • Fig. 3. Venography of the left leg revealed dilated superficial veins in the subcutaneous tissues (A) and aneurysmal dilatation of the left common (white arrow) and internal iliac veins (black arrow) (B).


Reference

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