Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy  

作　　者：Min Seon Park Beom Jae Lee Dae Hoe Gu Jeung-Hui Pyo Kyeong Jin Kim Yun Ho Lee Moon Kyung Joo Jong-Jae Park Jae Seon Kim Young-Tae Bak 

机构地区：[1]Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea

出　　处：《World Journal of Gastroenterology》2013年第45期8440-8444,共5页世界胃肠病学杂志（英文版）

摘　　要：Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage.It causes protein-losing enteropathy and may lead to gastrointestinal bleeding.Commonly,lymphangiectasia presents as whitish spots or specks.To our knowledge,small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported.Here,we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature.An 80-year-old woman was hospitalized for melena.Esophagogastroduodenoscopy could not identify the source of bleeding.Subsequent colonoscopy showed fresh bloody material gushing from the small bowel.An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings.Video capsule endoscopy showed evidence of active and recent bleeding in the ileum.To localize the bleeding site,we performed double balloon enteroscopy by the anal approach.A small,bleeding,polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.

关 键 词：Intestinal LYMPHANGIECTASIA Small bowel BLEEDING Double balloon endoscopy SOLITARY ILEAL POLYPOID lesion Endoscopic POLYPECTOMY 

分 类 号：R656.7[医药卫生—外科学]