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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2018; 24(1): 157-160
Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.157
Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.157
Emergent single-balloon enteroscopy for overt bleeding of small intestinal vascular malformation
Chen-Shuan Chung, Kuan-Chih Chen, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
Chen-Shuan Chung, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
Chen-Shuan Chung, Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Taoyuan City 33305, Taiwan
Yueh-Hung Chou, Department of Anatomical Pathology, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
Kuo-Hsin Chen, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
Kuo-Hsin Chen, Department of Electrical Engineering, Yuan Ze University, New Taipei City 22060, Taiwan
Author contributions: Chung CS and Chen KC collected data; Chung CS drafted the manuscript; Chou YH reviewed the pathology; Chen KH managed the surgical operations; Chung CS designed and supervised the study; all authors have read and approved the final version to be published.
Informed consent statement: Patient’s privacy is concealed by this retrospective case report and there is no informed consent needed.
Conflict-of-interest statement: The authors declare no conflict of interest.
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: Chen-Shuan Chung, MD, MSc, Chief Doctor, Lecturer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Nan-Ya South Road, Section 2, Banciao District, Taipei 22060, Taiwan. chungchenshuan_3@yahoo.com.tw
Telephone: +886-2-89667000-1704 Fax: +886-2-89665567
Received: October 25, 2017
Peer-review started: October 26, 2017
First decision: November 21, 2017
Revised: December 1, 2017
Accepted: December 4, 2017
Article in press: December 4, 2017
Published online: January 7, 2018
Processing time: 73 Days and 20.1 Hours
Peer-review started: October 26, 2017
First decision: November 21, 2017
Revised: December 1, 2017
Accepted: December 4, 2017
Article in press: December 4, 2017
Published online: January 7, 2018
Processing time: 73 Days and 20.1 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A young man presenting massive tarry stool passage with unstable hemodynamics.
Clinical diagnosis
Overt small intestinal bleeding.
Differential diagnosis
Vascular lesions of small intestine, Meckel’s diverticulum.
Laboratory diagnosis
Severe anemia.
Imaging diagnosis
An active bleeder, probably from the jejunal branches, with contrast extravasation into the bowel lumen was detected by emergent angiography.
Pathological diagnosis
Vascular malformation in the submucosa with organizing thrombus in the jejunum.
Treatment
Laparoscopic small intestinal resection after localization of bleeder by emergent single-balloon enteroscopy.
Related reports
Early endoscopic intervention may allow for earlier stabilization and shorter hospital stays.
Experiences and lessons
Emergent DAE is more useful than other non-invasive diagnostic modalities in the treatment of clinically overt small intestinal bleeding.