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Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic
Soo Jin Bae1, Geol Hwang1, Hyun Sik Kang1
1Department of Pediatrics, Jeju National University College of Medicine, Jeju, Korea.
Insights
Diagnosing small bowel hemangiomas in children is challenging. Capsule endoscopy identified a jejunal cavernous hemangioma in a boy with severe iron-deficiency anemia, leading to successful surgical removal.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Oncology
Background:
- Cavernous hemangiomas of the gastrointestinal tract are rare, especially in children.
- Diagnosing small bowel hemangiomas in pediatric patients presents significant challenges.
- Recurrent iron-deficiency anemia can be an atypical presentation of occult gastrointestinal lesions.
Purpose of the Study:
- To report a rare case of pediatric small bowel cavernous hemangioma.
- To highlight the diagnostic utility of capsule endoscopy in obscure gastrointestinal bleeding.
- To emphasize the importance of considering rare diagnoses in persistent pediatric anemia.
Main Methods:
- A 13-year-old boy with chronic iron-deficiency anemia was evaluated.
- Standard endoscopic procedures (gastroduodenoscopy, colonoscopy) were performed and yielded negative results.
- Capsule endoscopy was utilized for small bowel visualization, followed by surgical excision of the identified lesion.
Main Results:
- The patient presented with severe, recurrent iron-deficiency anemia without overt signs of gastrointestinal bleeding.
- Capsule endoscopy revealed a purplish, stalked mass in the jejunum.
- Surgical excision of the jejunal mass confirmed it as a cavernous hemangioma.
Conclusions:
- Small bowel cavernous hemangioma can cause severe iron-deficiency anemia in children, even without obvious bleeding symptoms.
- Capsule endoscopy is a valuable tool for diagnosing obscure gastrointestinal lesions in pediatric patients.
- Early diagnosis and surgical intervention are crucial for managing symptomatic gastrointestinal hemangiomas in children.
Abstract:
Cavernous hemangiomas of the gastrointestinal tract are extremely rare. In particular, the diagnosis of small bowel hemangiomas is very difficult in children. A 13-year-old boy presented at the outpatient clinic with dizziness and fatigue. The patient was previously diagnosed with iron-deficiency anemia at 3 years of age and had been treated with iron supplements continuously and pure red cell transfusion intermittently. Laboratory tests indicated that the patient currently had iron-deficiency anemia. There was no evidence of gross bleeding, such as hematemesis or bloody stool. Laboratory findings indicated no bleeding tendency. Gastroduodenoscopy and colonoscopy results were negative. To obtain a definitive diagnosis, the patient underwent capsule endoscopy. A purplish stalked mass was found in the jejunum, and the mass was excised successfully. We report of a 13-year-old boy who presented with severe and recurrent iron-deficiency anemia caused by a cavernous hemangioma in the small bowel without symptoms of gastrointestinal bleeding.
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