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

BMJ Case Rep. 2018 Jul 24:2018:bcr2018224536. doi: 10.1136/bcr-2018-224536.

Abstract

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.

Keywords: gi bleeding; paediatrics; radiology.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arteriovenous Malformations / complications
  • Arteriovenous Malformations / diagnosis*
  • Arteriovenous Malformations / pathology
  • Arteriovenous Malformations / surgery
  • Colonoscopy
  • Diagnosis, Differential
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Intestinal Polyps / complications
  • Intestinal Polyps / diagnosis*
  • Intestinal Polyps / pathology
  • Intestinal Polyps / surgery
  • Intestine, Small*
  • Male