Hemangioma of the rectum - a rare cause of peranal bleeding

A 19-year-old woman suffered from recurrent peranal hemorrhage. Over a peri od of five years she was treated under the suspicion of ulcerative colitis. After a sig mold resection with a colostomy, proctectomy with an end colos tomy followed due to recurrent intractable peranal hemorrhage. Histology of the specimen showed surprisingly a hemangioma of the rectum. Thereafter re construction was performed by colopouchanal anastomosis. Afterwards the pat ient was free of disease and had a good stool-continence. Stool-frequency w as twice daily. The second case consisted in a 27-year-old woman who underw ent emergency sigmoidectomy due to mas sive peranal hemorrhage. Here as wel l diagnosis was a hemangioma of the sigmoid. One year after the first opera tion the patient had a recurrence of peranal bleeding again due to rectal h emangioma. Since endoscopy and endosonography confirmed a rectal hemangioma a rectal exstirpation with a colopouchanal reconstruction was performed su ccessfully. The reviewed literature shows including the two presented cases a total of 81 cases with rectal hemangiomas. Because of the good results c oncerning function and morbidity the therapy of choice is rectal exstirpati on with colopouchanal reconstruction.