A CASE OF RUPTURED SUBMUCOSAL ANEURYSM OF THE SMALL INTESTINE OBSERVED BY DOUBLE-BALLOON ENTEROSCOPY

Abstract

A 39-year-old man was admitted to our hospital in a severe shock state following massive bloody stools. We performed upper and lower gastrointestinal endoscopic examinations and capsule ennedoscopy in order to locate the source of the bleeding. The capsule endoscopy revealed that the bleeding originated from the small intestine. Double-balloon enteroscopy revealed blood oozing from the smooth surface of an elevated lesion in the jejunum. Metallic clips and submucosal injection of black ink were applied adjacent to the lesion to mark the lesion. A partial jejunostomy was performed for the purpose of achieving hemostasis. The pathological diagnosis was a ruptured submucosal aneurysm. Herein, we have reported a rare case of a ruptured submucosal aneurysm in the small intestine detected by double-balloon enteroscopy. This experience indicated that a double-balloon endoteroscopy may be useful to clarify the location of a ruptured submucosal aneurysm in the small intestine and may increase the likelihood of achievement of rapid hemostasis.