Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1208-1214
Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1208
Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma: A case report
Kai-Rui Liu, Sheng Zhang, Wei-Run Chen, You-Xing Huang, Xu-Guang Li
Kai-Rui Liu, Sheng Zhang, Wei-Run Chen, You-Xing Huang, Department of Abdominal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Xu-Guang Li, Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Xu-Guang Li, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Author contributions: Liu KR and Li XG conceived and designed the study, read and analyzed the documents, and drafted the manuscript; Zhang S collected the medical data; Chen WR participated in the clinical assessment at each visit during the follow-up; Huang YX provided suggestions on the diagnosis and operation of the patients; Li XG performed the surgical resection. All the authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Xu-Guang Li, PhD, Chief Doctor, Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, No. 36 Mingxin Road, Liwan District, Guangzhou 510000, Guangdong Province, China.
Received: January 16, 2024
Peer-review started: January 16, 2024
First decision: February 2, 2024
Revised: February 14, 2024
Accepted: March 21, 2024
Article in press: March 21, 2024
Published online: April 27, 2024

Lymphangiomas in the gastrointestinal tract are extremely rare in adults. As a benign lesion, small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis. However, lymphangiomas can give rise to complications such as abdominal pain, bleeding, volvulus, and intussusception. Here, we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.


A 66-year-old man presented with intermittent melena, fatigue and refractory anemia nine months prior. Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding. Conservative management, including transfusion, hemostasis, gastric acid secretion inhibition and symptomatic treatment, was performed, but the lesions tended to recur shortly after surgery. Ultimately, the patient underwent capsule endoscopy, which revealed a more than 10 cm lesion accompanied by active bleeding. After single-balloon enteroscopy and biopsy, a diagnosis of jejunal cavernous lymphangioma was confirmed, and the patient underwent surgical resection. No complications or recurrences were observed postoperatively.


Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding. Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis. Surgical resection is an effective management method.

Keywords: Intermittent melena, Refractory anemia, Capsule endoscopy, Single-balloon enteroscopy, Jejunal cavernous lymphangioma, Enterectomy, Case report

Core Tip: We report a patient with recurrent melena and refractory anemia that was misdiagnosed as obscure gastrointestinal bleeding or intestinal ischemia for 9 months. A definite diagnosis of jejunal cavernous lymphangioma was made through capsule endoscopy, double-balloon enteroscopy, and biopsy. After surgical resection of the lesion, both the melena and anemia resolved.