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Giant “Tree Branch” Arteriovenous Malformation of the Hepatic Angle

A 65-year-old woman was referred for colonoscopy due to altered bowel habits without anemia or gastrointestinal blood loss. Colonoscopy revealed a giant “tree branch” arteriovenous malformation with hemi-circumferential involvement of the hepatic angle (Fig. 1) and a bluish protrusion of the colonic wall (Fig. 2), suggestive of a vascular structure. Computed tomography and angiography were performed revealing an arteriovenous malformation measuring 14 mm (Fig. 3), originating from a branch of the right colonic artery. The malformation had a preferential venous component due to the predominance of late vascularization, and, therefore, it was not embolized. The patient maintains vigilance without gastrointestinal blood loss or anemia. Arteriovenous malformations are aberrant vessels with thickened and hypertrophic walls. Although they are found mainly in the extremities, they may occur anywhere in the vascular tree [1]. In the colon, they are rare,