Case Report
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World J Gastroenterol. Oct 14, 2014; 20(38): 14076-14078
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.14076
Small intestinal vascular malformation bleeding: A case report with imaging findings
Jun Cui, Liu-Ye Huang, Shu-Juan Lin, Long-Zhi Yi, Cheng-Rong Wu, Bo Zhang
Jun 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
Author contributions: Cui J, Huang LY and Lin SJ designed and initiated the study; Lin SJ performed small intestinal endoscopy; Lin SJ and Yi LZ performed a literature search; additional cross-referencing was performed by Wu CR and Zhang B; Cui J drafted and wrote the paper.
Correspondence to: Dr. Lin Shu-Juan, Department of Gastroenterology, Yan tai Yu Huang Ding Hospital, Zhifu District, Yuhuangding east Road 20, Yantai 264000, Shandong Province, China. sdlsj123@126.com
Telephone: +86-535-6691999 Fax: +86-535-6240341
Received: March 6, 2014
Revised: April 29, 2014
Accepted: June 21, 2014
Published online: October 14, 2014
Processing time: 223 Days and 18 Hours
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.

Keywords: Small intestine; Vascular malformation; Bleeding; Imaging; Diagnosis

Core tip: 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 lesion was detected by anal approach enteroscopy; however, gastrointestinal tract bleeding occurred for an unknown reason. Ileal vascular malformation was detected by abdominal vascular enhanced computed tomography, and ileal angioma and vascular malformation were detected by a laparoscopic approach. 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.