A case report of gastrointestinal hemorrhage caused by small intestinal hemangioma

Abstract

Rationale: Small intestinal hemangioma is a rare condition and very difficult to diagnose preoperatively. It can occur in all segments of the small intestine, but jejunum is common. Its common symptoms are gastrointestinal bleeding and chronic anemia, while intussusception, intestinal obstruction and perforation are rare. In recent years, the popularization and application of capsule endoscopy, computed tomographic enterography and double-balloon enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. We report a case of gastrointestinal hemorrhage caused by of the small intestine hemangioma. Patient concerns: A 56-year-old male complaint of hematochezia for 1 day with dizziness, fatigue, and vomiting of gastric contents. Diagnosis: Based on the clinical, laboratory, imaging tests, endoscopy, laparoscopic approach and pathological examination, the patient was diagnosed with small intestinal hemangioma. Interventions: Segmental resection was performed for the small intestinal hemangioma by a laparoscopic approach. Outcomes: The patient was discharged without operation complications, and his hemoglobin increased to 130 g/L at the second month after the operation. Lessons: Small intestinal hemangioma is a rare condition without specific symptoms and can cause gastrointestinal bleeding. The possibility of small intestinal hemangioma should be considered with unexplained gastrointestinal bleeding. Surgical resection is the preferred treatment option for symptomatic hemangiomas. Furthermore, double-balloon enteroscopy can increase the diagnostic yield. Applying endoscopic titanium clip combined with Indian ink marking can obtain an accurate positioning before surgery.