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BMJ Case Reports 2018; doi:10.1136/bcr-2018-224536
  • Rare disease
  • CASE REPORT

Small intestine polypoid arteriovenous malformation: a stepwise approach to diagnosis in a paediatric case

  1. Nicholas CaJacob
  1. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Dr Adolfo Leonel Molina, AMolina{at}uabmc.edu
  • Accepted 26 June 2018
  • Published 24 July 2018

Summary

We report a case of acute gastrointestinal haemorrhage due to a small intestine polypoid arteriovenous malformation (AVM) in a patient with a remote history of obscure gastrointestinal bleeding (OGIB) 8 years earlier. The diagnosis of a small intestine AVM was made using video capsule endoscopy (VCE) and confirmed using single-balloon push enteroscopy. The lesion was marked with submucosal tattoo to aid in subsequent surgical resection of the lesion with primary duodenoduodenostomy. Since our patient’s initial bleeding episode, a variety of advanced tools have become widely available to aid in the localisation of OGIB. This case illustrates the use of a stepwise approach using new medical technology to identify and manage OGIB in children. VCE and push enteroscopy proved to be important diagnostic modalities in this paediatric case.

Footnotes

  • Contributors ALM is the primary author, drafted the initial manuscript and approved the final manuscript as submitted. He also cared for this patient during their hospitalisation. TJ provided project leadership and content, critically reviewed and approved the final manuscript as submitted. She also cared for this patient during their hospitalisation. JN provided project leadership and content, critically reviewed and approved the final manuscript as submitted. She also cared for this patient during their hospitalisation. JN provided project leadership and content, critically reviewed and approved the final manuscript as submitted. He also cared for this patient during their hospitalisation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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