Rohan LUTHRA, Natasha GUPTA, Parveen KUMAR
The Turkish Journal of Pediatrics - 2026;68(5):874-881
Background. Arteriovenous malformations (AVMs) are rare causes of lower gastrointestinal bleeding in the pediatric population. Case Presentation. We report two female children aged 3 and 7 years old with multiple episodes of hematochezia and severe anemia who underwent computed tomography angiography. The first case demonstrated diffuse concentric wall thickening with small calcifications (phleboliths) involving the sigmoid colon and rectum. The affected segments demonstrated moderate progressive enhancement, along with an arcade of prominent vascular channels in the pericolic fat. The second case demonstrated hyperdense wall thickening involving the descending colon and proximal sigmoid colon with intense homogeneous contrast enhancement and an arcade of prominent vessels along the left colon. In both cases, the feeding arteries arose from the inferior mesenteric artery and the venous drainage was into the inferior mesenteric vein. Our first case was subjected to ligation of inferior mesenteric vascular pedicle feeding and draining the AVM, which succeeded in controlling bleeding episodes, while the second patient, who presented with relatively milder symptoms, underwent embolization therapy. Conclusion. Vascular malformations of the bowel should be considered in pediatric age group in cases of lower gastrointestinal bleed.
