Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy

Figure 1 Colonoscopy and video capsule endoscopy findings. A-C: Colonoscopy shows fresh blood material that gushed from the small bowel; D: Subsequent video capsule endoscopy shows evidence of active and recent bleeding in the ileum.

Figure 2 Double balloon enteroscopy findings. A: Double balloon enteroscopy shows a small, whitish polypoid lesion with active bleeding in the distal ileum; B, C: After submucosal injection of a saline-epinephrine mixture, polypectomy was performed; D: After the procedure, argon plasma coagulation was performed on the post-polypectomy ulcer to achieve hemostasis.

Figure 3 Histopathologic findings of intestinal lymphangiectasia. A, B: Microscopic examination shows dilated lymphatic channels in the lamina propria (hematoxylin and eosin, × 40). Protein-rich fluid can escape from these channels into the extracellular space of the lamina propria and ultimately into the gut lumen (hematoxylin and eosin, × 200).