Abstract
A 69-year-old man presented to the emergency room with hematochezia. We performed video capsule enteroscopy (VCE), and active bleeding was found at the ileum. On the following day, balloon enteroscopy (BAE) was performed. No active bleeding was observed. A solitary submucosal tumor (SMT) was observed approximately 100cm from Bauhin's valve. We performed clipping to mark the location of the SMT. Two days after clipping, melena recurred, and the patient's blood pressure (BP) decreased. CT angiography showed intestinal varices, which had formed by the clipping. Two days later, the patient was administered 2.0 ml of N-butyl-2-cyanoacrylate by endoscopic injection sclerotherapy (EIS) with BAE. Thereafter, the melena ceased, and the patient's BP and hemoglobin level normalized.
Because of difficulties in diagnosis and treatment, bleeding from ileal varices is generally massive and life-threatening. BAE is a useful modality for patients with bleeding from ileal varices.
