Solitary hemangioma of the small bowel disclosed by wireless capsule endoscopy

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Diagnostic Endoscopy

Background:

• Small bowel hemangiomas are rare vascular malformations causing gastrointestinal bleeding.
• Diagnosis is challenging, often requiring extensive workup and sometimes discovered intraoperatively.
• Recurrent melena and anemia in a child prompted further investigation after initial negative endoscopic evaluations.

Observation:

• A nine-year-old child presented with recurrent melena and anemia.
• Previous investigations including upper/lower endoscopy and 99m-Tc-RBC-scintigraphy were inconclusive or non-specific.
• Capsule endoscopy revealed a bleeding hemangioma in the ileum.

Findings:

• Pathological examination confirmed a transmural cavernous hemangioma of the ileum.
• The hemangioma was successfully resected.
• Capsule endoscopy facilitated accurate preoperative localization of the small bowel lesion.

Implications:

• Capsule endoscopy can significantly improve the preoperative diagnosis of rare small bowel tumors.
• Early and accurate diagnosis of small bowel hemangiomas can lead to timely surgical intervention.
• This case highlights the utility of capsule endoscopy in pediatric gastrointestinal bleeding of obscure origin.