Takase N, Fukui K, Tani T, Nishimura T, Tanaka T, Harada N, Ueno K, Takamatsu M, Nishizawa A, Okamura A, Kaneda K. Preoperative detection and localization of small bowel hemangioma: Two case reports. World J Gastroenterol 2017; 23(20): 3752-3757 [PMID: 28611528 DOI: 10.3748/wjg.v23.i20.3752]
Corresponding Author of This Article
Kunihiko Kaneda, MD, PhD, Department of Surgery, Kakogawa Central City Hospital, 439, Honmachi, Kakogawa-cho, Kakogawa 675-8611, Japan. k-kaneda@kakohp.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nobuhisa Takase, Keisuke Fukui, Takafumi Tani, Tohru Nishimura, Tomohiro Tanaka, Naoki Harada, Kimihiko Ueno, Manabu Takamatsu, Kunihiko Kaneda, Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
Akihiko Nishizawa, Department of Internal Medicine, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
Akiharu Okamura, Department of Diagnostic Pathology, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
Author contributions: Harada N and Nishizawa A operated on the patient and designed the report; Fukui K, Tani T, Nishimura T, Tanaka T, Ueno K, Takamatsu M and Okamura A drafted the paper; Kaneda K critically revised the paper with an important conceptual and editorial input; and all authors contributed to this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Kakogawa Central City Hospital, Kakogawa, Japan.
Informed consent statement: The patients participating in the study provided informed written consent.
Conflict-of-interest statement: The authors declare no conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kunihiko Kaneda, MD, PhD, Department of Surgery, Kakogawa Central City Hospital, 439, Honmachi, Kakogawa-cho, Kakogawa 675-8611, Japan. k-kaneda@kakohp.jp
Telephone: +81-79-4515500 Fax: +81-79-4515548
Received: February 16, 2017 Peer-review started: February 17, 2017 First decision: March 3, 2017 Revised: March 17, 2017 Accepted: April 12, 2017 Article in press: April 12, 2017 Published online: May 28, 2017 Processing time: 99 Days and 3.7 Hours
Abstract
Among the various diagnostic modalities for small bowel hemangioma, video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) can be recommended as part of the work-up in patients with obscure gastrointestinal bleeding (OGIB). DBE is superior to VCE in the accuracy of diagnosis and therapeutic potential, while in most cases total enteroscopy cannot be achieved through only the antegrade or retrograde DBE procedures. As treatment for small bowel bleeding, especially spout bleeding, localization of the lesion for the decision of DBE insertion facilitates early treatment, such as endoscopic hemostatic clipping, allowing patients to avoid useless transfusion and the worsening of their disease into life-threatening status. Applying endoscopic India ink marking prior to laparoscopic surgical resection is a particularly useful technique for more minimally invasive treatment. We report two cases of small bowel hemangioma found in examinations for OGIB that were treated with combination of laparoscopic and endoscopic modalities.
Core tip: Small bowel hemangioma is a relatively rare small bowel tumor and can cause gastrointestinal bleeding, which often results in a diagnostic dilemma. video capsule endoscopy (VCE) and double-balloon enteroscopy are both useful modalities for the diagnosis of small bowel disease with obscure gastrointestinal bleeding including hemangioma, and preceding observation by VCE can result in a synergistic treatment effect. Furthermore, applying endoscopic India ink marking prior to laparoscopic surgical resection is a useful technique for achieving minimally invasive treatment.
