Multiple angiodysplasia diagnosed by capsule endoscopy

Area of Science:

• Gastroenterology
• Vascular Medicine

Background:

• Acute massive rectal bleeding can be a challenging clinical presentation.
• Diagnostic evaluation for obscure gastrointestinal bleeding often requires advanced imaging and endoscopic techniques.

Observation:

• A 28-year-old male presented with acute massive rectal bleeding requiring transfusion.
• Initial investigations including CT and endoscopy did not identify the bleeding source.
• Video capsule endoscopy revealed multiple jejunal and ileal angiodysplastic lesions.

Findings:

• Angiodysplastic lesions in the small intestine were identified as the cause of obscure gastrointestinal bleeding.
• Endoscopic argon plasma coagulation was successfully employed to treat the angiodysplasias.
• The procedure was performed uneventfully via upper and rectal approaches.

Implications:

• Argon plasma coagulation is an effective endoscopic treatment for small intestine angiodysplasias.
• This case highlights the utility of video capsule endoscopy in diagnosing obscure gastrointestinal bleeding.
• Successful treatment led to a sustained absence of gastrointestinal bleeding during a 2-year follow-up.