Small Intestinal Arteriovenous Malformation Treated by Double-balloon Endoscopy

Area of Science:

• Gastroenterology
• Vascular Surgery
• Diagnostic Imaging

Background:

• Anemia of unknown origin can be challenging to diagnose.
• Small intestinal arteriovenous malformations (AVMs) are rare vascular anomalies that can cause gastrointestinal bleeding.
• Conventional endoscopic methods may fail to identify bleeding sources in the small bowel.

Observation:

• A 42-year-old male presented with anemia, with no bleeding source identified by gastroscopy or colonoscopy.
• Abdominal contrast-enhanced computed tomography (CT) revealed vascular dilatation in the small intestine.
• Small bowel capsule endoscopy and antegrade double-balloon endoscopy (DBE) confirmed a small intestinal AVM.

Findings:

• The small intestinal AVM was successfully clipped using antegrade double-balloon endoscopy (DBE).
• Post-procedure imaging, including contrast-enhanced CT and small bowel angiography, demonstrated complete resolution of the AVM.
• The patient's anemia resolved following the AVM treatment.

Implications:

• Double-balloon endoscopy (DBE) provides a minimally invasive therapeutic option for treating small intestinal arteriovenous malformations.
• DBE can effectively clip AVMs, potentially avoiding the need for surgical intervention and its associated risks.
• This approach enhances diagnostic and therapeutic capabilities for obscure gastrointestinal bleeding originating from the small intestine.