Management of Multiple Arteriovenous Malformations of the Small Bowel
A 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the p...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/2046857 |
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| author | Masahiro Hirakawa Rie Ishizuka Masanori Sato Naotaka Hayasaka Hiroyuki Ohnuma Kazuyuki Murase Kohichi Takada Tatsuya Ito Takayuki Nobuoka Koji Miyanishi Masayoshi Kobune Ichiro Takemasa Junji Kato |
| author_facet | Masahiro Hirakawa Rie Ishizuka Masanori Sato Naotaka Hayasaka Hiroyuki Ohnuma Kazuyuki Murase Kohichi Takada Tatsuya Ito Takayuki Nobuoka Koji Miyanishi Masayoshi Kobune Ichiro Takemasa Junji Kato |
| author_sort | Masahiro Hirakawa |
| collection | DOAJ |
| description | A 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the patient had recurrent intermittent bloody stools with a significant decrease in hemoglobin levels. Although no active bleeding was observed on antegrade DBE, we detected a pulsatile submucosal uplift accompanied by a small red patch on the top of the uplift in the jejunum. Arteriovenous malformation (AVM) was suspected as the cause of small-bowel bleeding. Multiple-phase CT showed a number of small vascular ectasias during the arterial phase in the jejunum, and we confirmed the presence of multiple AVMs in the jejunum by selective angiography. To identify the location of the lesions and determine the minimal surgical margins, we performed intraoperative selective angiography with indocyanine green (ICG) injection. This technique allowed us to clearly observe the region and perform segmental small-bowel resection with minimal surgical margin. The patient reported that she has had no gastrointestinal bleeding at the two years follow-up visit. |
| format | Article |
| id | doaj-art-678bcbe8770a4b3ea228c037bb18a9ed |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-678bcbe8770a4b3ea228c037bb18a9ed2025-02-03T01:03:32ZengWileyCase Reports in Medicine1687-96271687-96352019-01-01201910.1155/2019/20468572046857Management of Multiple Arteriovenous Malformations of the Small BowelMasahiro Hirakawa0Rie Ishizuka1Masanori Sato2Naotaka Hayasaka3Hiroyuki Ohnuma4Kazuyuki Murase5Kohichi Takada6Tatsuya Ito7Takayuki Nobuoka8Koji Miyanishi9Masayoshi Kobune10Ichiro Takemasa11Junji Kato12Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Hematology, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, JapanA 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the patient had recurrent intermittent bloody stools with a significant decrease in hemoglobin levels. Although no active bleeding was observed on antegrade DBE, we detected a pulsatile submucosal uplift accompanied by a small red patch on the top of the uplift in the jejunum. Arteriovenous malformation (AVM) was suspected as the cause of small-bowel bleeding. Multiple-phase CT showed a number of small vascular ectasias during the arterial phase in the jejunum, and we confirmed the presence of multiple AVMs in the jejunum by selective angiography. To identify the location of the lesions and determine the minimal surgical margins, we performed intraoperative selective angiography with indocyanine green (ICG) injection. This technique allowed us to clearly observe the region and perform segmental small-bowel resection with minimal surgical margin. The patient reported that she has had no gastrointestinal bleeding at the two years follow-up visit.http://dx.doi.org/10.1155/2019/2046857 |
| spellingShingle | Masahiro Hirakawa Rie Ishizuka Masanori Sato Naotaka Hayasaka Hiroyuki Ohnuma Kazuyuki Murase Kohichi Takada Tatsuya Ito Takayuki Nobuoka Koji Miyanishi Masayoshi Kobune Ichiro Takemasa Junji Kato Management of Multiple Arteriovenous Malformations of the Small Bowel Case Reports in Medicine |
| title | Management of Multiple Arteriovenous Malformations of the Small Bowel |
| title_full | Management of Multiple Arteriovenous Malformations of the Small Bowel |
| title_fullStr | Management of Multiple Arteriovenous Malformations of the Small Bowel |
| title_full_unstemmed | Management of Multiple Arteriovenous Malformations of the Small Bowel |
| title_short | Management of Multiple Arteriovenous Malformations of the Small Bowel |
| title_sort | management of multiple arteriovenous malformations of the small bowel |
| url | http://dx.doi.org/10.1155/2019/2046857 |
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