Obscure Gastrointestinal Bleeding Caused by a Small Intestinal Lymphatic-venous Malformation: A Case Report with a Literature Review

Yasuhiko Hamada; Yuhei Umeda; Yohei Ikenoyama; Akina Shigefuku; Hiroki Yukimoto; Misaki Nakamura; Masaki Katsurahara; Kyosuke Tanaka; Noriyuki Horiki; Yuka Sugimoto; Hayato Nakagawa

doi:10.2169/internalmedicine.9733-22

This article has now been updated. Please use the final version.

Obscure Gastrointestinal Bleeding Caused by a Small Intestinal Lymphatic-venous Malformation: A Case Report with a Literature Review

Yasuhiko Hamada, Yuhei Umeda, Yohei Ikenoyama, Akina Shigefuku, Hiroki Yukimoto, Misaki Nakamura, Masaki Katsurahara, Kyosuke Tanaka, Noriyuki Horiki, Yuka Sugimoto, Hayato Nakagawa

Author information

Yasuhiko Hamada
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Yuhei Umeda
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Yohei Ikenoyama
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Akina Shigefuku
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Hiroki Yukimoto
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Misaki Nakamura
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Masaki Katsurahara
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Kyosuke Tanaka
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Noriyuki Horiki
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
Yuka Sugimoto
Department of Hematology and Oncology, Mie University Hospital, Japan
Hayato Nakagawa
Department of Gastroenterology and Hepatology, Mie University Hospital, Japan

Keywords: capsule endoscopy, enteroscopy, gastrointestinal bleeding, vascular malformation, small intestine

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9733-22

DOI https://doi.org/10.2169/internalmedicine.9733-22

The final version of this article is now available: Vol. 62 (2023), No. 3 pp. 387-391

Details

Abstract

A 44-year-old woman presented with severe anemia. We strongly suspected gastrointestinal bleeding; however, esophagogastroduodenoscopy, colonoscopy, and computed tomography showed no bleeding sources. Video capsule endoscopy revealed an actively bleeding submucosal lesion within the jejunum. Double-balloon enteroscopy revealed a 20-mm continuously bleeding submucosal lesion in the distal jejunum. We suspected small intestinal vascular malformation and performed surgical resection. The resected specimen pathologically comprised dilated, thin-walled lymphatic channels and blood vessels involving the small intestinal submucosa. Therefore, the patient was diagnosed with small intestinal lymphatic-venous malformation. Postoperatively, the patient recovered well, and recurrence was not observed.

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