Combined capillary hemangioma and angiodysplasia of the ileum: An unusual cause of obscure gastrointestinal bleeding with preoperative localization by double-balloon endoscopy

Department of General Surgery, Changhua Christian Hospital, Taiwan.
American journal of surgery (Impact Factor: 2.29). 04/2010; 200(2):e30-2. DOI: 10.1016/j.amjsurg.2009.11.015
Source: PubMed


Vascular lesions in the small bowel with bleeding complications are usually difficult to diagnose and localize preoperatively. With the increased use of either capsule endoscopy or enteroscopy, there have been more reports of preoperative diagnosis from such lesions. The authors report a rare case of obscure gastrointestinal bleeding from a combined hemangioma and angiodysplasia identified by double-balloon enteroscopy. To the authors' knowledge, this is the first report of such combined lesions.

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    • "entrance into previously unexplored areas of the deep intestines; therefore, the diagnostic skills to recognize hemangiomas are becoming more attainable for endoscopists . Similar to our patient, previous endoscopy reports of intestinal hemangiomas have described them as typically submucosal [1] [2] [4] [5] [8], purple to red [4] [5] [9], soft [5] [9], and pedunculated [4] [9] or sessile [8]. It is remarkable that superficial capillary networks and fine varicosities in our patient strongly suggested the vascular nature of the lesion. "
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    ABSTRACT: We report a 27-year-old female with chronic iron deficiency anemia and unexplained fecal occult blood. Abdominal ultrasonography and computed tomography disclosed a possible endoluminal lesion in the small intestine. Single-balloon enteroscopy detected the target lesion in the proximal ileum. The lesion was a 2.5-cm submucosal tumor that was purple-red, soft, had a narrow base, and exhibited superficial telangiectasia. After endoscopic marking, the tumor was resected with minimally invasive laparoscopy. It was histologically confirmed as a cavernous hemangioma. In this report, we discuss the endoscopic characteristics, surgical and pathological assessment, and management strategy of hemangiomas in the small intestine.
    Full-text · Article · Feb 2015