Published online Dec 7, 2013. doi: 10.3748/wjg.v19.i45.8440
Revised: September 17, 2013
Accepted: September 29, 2013
Published online: December 7, 2013
Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.
Core tip: Intestinal lymphangiectasia is a relatively rare disease. To date, only a few cases of small bowel bleeding resulting from intestinal lymphangiectasia have been reported. Herein, we report a case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature.