Clinical features:
(1) The patient experiences episodes of painless rectal bleeding, which can be severe. The episodes may be acute or chronic, intermittent or continuous.
(2) The onset of rectal bleeding can be at any age.
(3) Variable lumbar, pelvic or perianal pain.
(4) Variable hematuria.
Aspirin or anticoagulant therapy could increase the frequency and severity of bleeding.
If the diagnosis is suspected then imaging studies can substantiate the diagnosis. Biopsy can either miss the lesion or cause significant hemorrhage.
Imaging is also valuable in determining the extent of the lesion and its blood supply which can be important in planning surgery.
Differential diagnosis:
(1) internal hemorrhoids (which can co-exist with a rectal hemangioma)
(2) malignant vascular tumor
(3) other malignant tumor of the rectum
(4) ulcerative colitis
