Diffuse cavernous hemangioma of the rectosigmoid is a rare lesion usually presented in children and young adult, often with life threatening hemorrhage. The clinical diagnosis is difficult and often delayed because of lack of awareness of the clinical features. We report a case of diffuse cavernous hemangioma of the rectosigmoid in a 12-year-old boy who had undergone suture ligation under the impression of hemorrhoid at his age 3. Sphincter-saving coloanal pull through procedure were applied as the surgical treatment. Sclerotherapy was needed with recurrent rectal bleeding 6 months after the pull through operation. The patient is well at 12 months follow-up.
Because rectal prolapse in pediatric age was known to have a self-limitting natural history in weeks to years, this disease is prone to be regarded as a minor codition to the most of surgeons. But to the children and the parents who have to be suffered each time could be a heavy distress. Even though operative or nonoperative methods can be applicable for treatment, the main problem is in surgeon's side, whose preference is based on the experiences of adult patients. The authors have experienced 16 cases of ano-rectal prolapse for 9 years since 1986. Eleven of them were true rectal prolapses. In 7 cases of true type, injection therapy has been tried. One ml of five per cent phenol in glycerine was injected into the submucosal layer of the ano-rectal angle level at both lateral and posterior sides. After first trial of each cases, 5 of them were cured completely so far. Recurrences were in two cases, but one of them was temporary to be subsided afterward. Complete bowel cleansing and adequate sedations were required as preoperative preparations. Two days' oral antibiotics and two weeks' laxatives for free of defecation straining were recommended after the procedure. The safety of sclerosis was supported by the experimental histology. In pediatric rectal prolapse, sclerosis seems to be a safe and effective treatement of choice without any significant morbidity.