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Small bowel capillary hemangioma
SMALL BOWEL CAPILLARY HEMANGIOMA
A 67-year-old woman was hospitalized because of hematochezia of 24 hours’ duration. Hematochezia had occurred 1 year earlier, but, despite EGD, colonoscopy, small bowel enteroclysis, and CT of the abdomen, no source was found. EGD revealed no evidence of bleeding; but, at colonoscopy, fresh blood was present throughout the colon and in the terminal ileum, although no focus of bleeding was identified. Capsule endoscopy discovered a hyperemic lesion with blood clot in the mid ileum (A). Intra-operative enteroscopy disclosed a small (3 3 3 3 1 mm) polypoid mass at 100 cm proximal to the ileocecal valve (B). The segment of ileum containing the lesion was resected surgically (C,D). Histopathologic examination revealed a capillary hemangioma (E; H&E, orig. mag. 3200). Yong Sik Kim, MD Hoon Jai Chun, MD, PhD Yoon Tae Jeen, MD, PhD Soon Ho Um, MD, PhD Chang Duck Kim, MD, PhD Jin Hai Hyun, MD, PhD Institute of Digestive Disease and Nutrition Korea University College of Medicine Seoul, Korea PII: S0016-5107(04)01859-0 VOLUME 60, NO. 4, 2004
GASTROINTESTINAL ENDOSCOPY
599
A 67-year-old woman was hospitalized because of hematochezia of 24 hours’ duration. Hematochezia had occurred 1 year earlier, but, despite EGD, colonoscopy, small bowel enteroclysis, and CT of the abdomen, no source was found. EGD revealed no evidence of bleeding; but, at colonoscopy, fresh blood was present throughout the colon and in the terminal ileum, although no focus of bleeding was identified. Capsule endoscopy discovered a hyperemic lesion with blood clot in the mid ileum (A). Intra-operative enteroscopy disclosed a small (3 3 3 3 1 mm) polypoid mass at 100 cm proximal to the ileocecal valve (B). The segment of ileum containing the lesion was resected surgically (C,D). Histopathologic examination revealed a capillary hemangioma (E; H&E, orig. mag. 3200). Yong Sik Kim, MD Hoon Jai Chun, MD, PhD Yoon Tae Jeen, MD, PhD Soon Ho Um, MD, PhD Chang Duck Kim, MD, PhD Jin Hai Hyun, MD, PhD Institute of Digestive Disease and Nutrition Korea University College of Medicine Seoul, Korea PII: S0016-5107(04)01859-0 VOLUME 60, NO. 4, 2004
GASTROINTESTINAL ENDOSCOPY
599