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24 September 2018 : Case report  China (mainland)

A Small Jejunal Angioleiomyoma Detected by Double-Balloon Enteroscopy: A Case Report

Rare disease

Xiao-Dong Shao1A*, Zhen-Dong Liang1E, Xiao-Zhong Guo1F

DOI: 10.12659/AJCR.910884

Am J Case Rep 2018; 19:1126-1128

Abstract

BACKGROUND: Angioleiomyoma in the small intestine is a rare cause of gastrointestinal bleeding. Only 7 cases of angioleiomyoma in the small intestine were reported in the English literature, with 4 of them causing gastrointestinal bleeding. The diagnosis of angioleiomyomas in the small intestine before surgery is difficult.

CASE REPORT: We report the case of a 42-year-old man with recurrent melena who underwent repeated esophagogastroduodenoscopy and colonoscopy, without positive finding. During a double-balloon enteroscopy, an elevated lesion with a diameter of 6 mm was found in the jejunum. The lesion was resected laparoscopically assisted with double-balloon enteroscpy. A microscopic examination showed fibric membrane of the mass and numerous vascular channels surrounded by proliferated smooth muscle. There were exudative fibrin and many thrombi formed by red blood cells. Immunohistochemistry was positive for SMA and CD34. A pathological diagnosis of jejunal angioleiomyoma with thrombus was established. During a 5-year follow-up, there was no further gastrointestinal bleeding.

CONCLUSIONS: The gastroenterologists should consider angioleiomyoma in the small intestine when assessing obscure gastrointestinal bleeding.

Keywords: Angiomyoma, Double-balloon enteroscopy, Gastrointestinal Hemorrhage, Intestine, Small

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923