Massive Bleeding from a Small Intestinal Submucosal Tumor-like Arterial Malformation: An Unclassifiable Vascular Lesion Revealed by a Detailed Pathological Evaluation

Kazuhiro Ota; Junki Noda; Hiroshi Akutagawa; Noriaki Sugawara; Kei Nakazawa; Shinya Nishida; Yuki Hirata; Satoshi Harada; Wataru Osumi; Yuichi Kojima; Sadaharu Nouda; Toshihisa Takeuchi; Yoshinobu Hirose; Kazuhide Higuchi

doi:10.2169/internalmedicine.3217-19

CASE REPORTS

Massive Bleeding from a Small Intestinal Submucosal Tumor-like Arterial Malformation: An Unclassifiable Vascular Lesion Revealed by a Detailed Pathological Evaluation

Kazuhiro Ota, Junki Noda, Hiroshi Akutagawa, Noriaki Sugawara, Kei Nakazawa, Shinya Nishida, Yuki Hirata, Satoshi Harada, Wataru Osumi, Yuichi Kojima, Sadaharu Nouda, Toshihisa Takeuchi, Yoshinobu Hirose, Kazuhide Higuchi

Author information

Kazuhiro Ota
Second Department of Internal Medicine, Osaka Medical College, Japan
Junki Noda
Second Department of Internal Medicine, Osaka Medical College, Japan
Hiroshi Akutagawa
Department of Pathology, Osaka Medical College, Japan
Noriaki Sugawara
Second Department of Internal Medicine, Osaka Medical College, Japan
Kei Nakazawa
Second Department of Internal Medicine, Osaka Medical College, Japan
Shinya Nishida
Second Department of Internal Medicine, Osaka Medical College, Japan
Yuki Hirata
Second Department of Internal Medicine, Osaka Medical College, Japan
Satoshi Harada
Second Department of Internal Medicine, Osaka Medical College, Japan
Wataru Osumi
Department of General and Gastroenterological Surgery, Osaka Medical College, Japan
Yuichi Kojima
Second Department of Internal Medicine, Osaka Medical College, Japan
Sadaharu Nouda
Second Department of Internal Medicine, Osaka Medical College, Japan
Toshihisa Takeuchi
Second Department of Internal Medicine, Osaka Medical College, Japan
Yoshinobu Hirose
Department of Pathology, Osaka Medical College, Japan
Kazuhide Higuchi
Second Department of Internal Medicine, Osaka Medical College, Japan

Keywords: obscure gastrointestinal bleeding, capsule endoscopy, small intestinal bleeding

JOURNAL OPEN ACCESS
Supplementary material

2019 Volume 58 Issue 24 Pages 3521-3523

DOI https://doi.org/10.2169/internalmedicine.3217-19

Browse “Advance online publication” version

Details

Abstract

A 53-year-old woman presented with repeated copious bloody stool. Small bowel capsule endoscopy revealed a submucosal tumor (SMT)-like lesion, with erosion of the surface, in the first third of the small bowel. Balloon-assisted small intestinal endoscopy also revealed a pulsatile SMT-like lesion with an exposed vessel on the surface. This unknown lesion was surgically resected. The histopathological findings of the resected SMT-like lesion showed a dilated artery with thrombosis blockage and recanalization. Since this case could not be classified as any of the small intestinal vascular lesion patterns endoscopically, its classification will require the accumulation of further cases.

Corresponding author

Register with J-STAGE for free!