Published online May 28, 2017. doi: 10.3748/wjg.v23.i20.3752
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
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.