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Small intestinal vascular malformation bleeding: a case report with imaging findings
Jun Cui1, Liu-Ye Huang1, Shu-Juan Lin1
1Jun Cui, Liu-Ye Huang, Shu-Juan Lin, Long-Zhi Yi, Cheng-Rong Wu, Bo Zhang, Department of Gastroenterology, Yan tai Yu Huang Ding Hospital, Yantai 264000, Shandong Province, China.
Abstract:
The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding of vascular malformations. Thus, the diagnosis of intestinal bleeding is very difficult. A 47-year-old man presented at the hospital 5 mo ago with dark stool. Several angiomas were detected by oral approach enteroscopy, but no active bleeding was observed. Additionally, no lesions were detected by anal approach enteroscopy; however, gastrointestinal tract bleeding still occurred for an unknown reason. We performed an abdominal vascular enhanced computed tomography examination and detected ileal vascular malformations. Ileum angioma and vascular malformation were detected by a laparoscopic approach, and segmental resection was performed for both lesions, which were confirmed by pathological diagnosis. This report systemically emphasizes the imaging findings of small intestinal vascular malformation bleeding.
Insights
Diagnosing small intestinal vascular malformations causing bleeding is challenging. Enhanced computed tomography and laparoscopic surgery successfully identified and treated ileal vascular malformations in a patient with obscure gastrointestinal bleeding.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Surgical Oncology
Background:
- Small intestinal vascular malformations are a difficult-to-diagnose cause of obscure gastrointestinal bleeding.
- Conventional diagnostic methods like endoscopy and X-ray are often insufficient for thorough small intestine examination.
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