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

Intern Med. 2023 Feb 1;62(3):387-391. doi: 10.2169/internalmedicine.9733-22. Epub 2022 Jun 21.

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.

Keywords: capsule endoscopy; enteroscopy; gastrointestinal bleeding; small intestine; vascular malformation.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Colonoscopy / adverse effects
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Intestine, Small* / blood supply
  • Intestine, Small* / diagnostic imaging
  • Intestine, Small* / surgery
  • Jejunum / diagnostic imaging
  • Jejunum / surgery
  • Vascular Malformations* / complications