Jejunal bleeding: a case report

Small intestinal bleeding remains a relatively uncommon event, accounting for 5-10% of all patients presenting with gastrointestinal bleeding. A rare but significant source includes hemangioma of the small intestine. Here we present a case of a 78-year-old female patient admitted with recurrent melena and iron deficiency anemia. After performing a normal upper and lower endoscopic examination, we suspected small bowel bleeding. Correspondingly, the patient underwent a video capsule endoscopy, showing a submucosal nodular lesion in the distal jejunum. Balloon enteroscopy clearly identified and inked the lesion, facilitating minimally invasive surgery. Pathology demonstrated a cavernous hemangioma. As we did not have a conclusive diagnosis preoperative and endoscopic intervention may have led to uncontrolled bleeding or perforation, laparoscopy was chosen to conduct a better evaluation. The present case findings emphasize that gastrointestinal hemangiomas, although uncommon, should be considered in the differential diagnosis of patients who present with unexplained gastrointestinal bleeding or other abdominal symptoms.

Keywords: hemangioma, small intestine, gastro-intestinal bleeding, obscure.