1.Cecal Polypoid Arteriovenous Malformations Removed by Endoscopic Biopsy.
Byung Kook KIM ; Hye Seung HAN ; Sun Young LEE ; Chi Hun KIM ; Choon Jo JIN
Journal of Korean Medical Science 2009;24(2):342-345
Colonic arteriovenous malformation (AVM) is one of the causes of lower gastrointestinal bleeding. Unlike small vascular ectasia or angiodysplasia, colonic AVM tends to be solitary, large in size, and identified endoscopically as flat or elevated bright red lesion. Herein, we report a case of non-solitary and small cecal AVMs which were removed by endoscopic biopsy. A 66-yr-old woman was referred for routine gastrointestinal cancer screening. She was suffering from diabetes, hypertension, end-stage renal disease, and anemia of chronic disease. On colonoscopic finding, three semi-pedunculated polyps, less than 5 mm in size, were noticed near to the appendiceal orifice. Since the lesions revealed normal-looking epithelium with converging folds on the cecal base, lesions were diagnosed as inflammatory polyps on gross finding. Three biopsies were taken from each lesion. Bleeding from the biopsied site ceased spontaneously. Histopathologic evaluation demonstrated intramucosal hemorrhage and dilated submucosal vessels which were consistent with polypoid colonic AVMs.
Aged
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Arteriovenous Malformations/*diagnosis/pathology/surgery
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Biopsy
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Cecum/blood supply/pathology
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Colon/*blood supply/pathology
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Colonic Polyps/pathology/*surgery
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Colonoscopy
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Female
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Humans
2.Massive Gastrointestinal Bleeding due to Aneurysmal Rupture of Ileo-colic Artery in a Patient with Behcet's Disease.
Seung Up KIM ; Jae Hee CHEON ; Joon Seok LIM ; Seung Hyuk PAIK ; Sang Kyum KIM ; Sang Kil LEE ; Yong Chan LEE ; Won Ho KIM
The Korean Journal of Gastroenterology 2007;49(6):400-404
Behcet's disease has been recognized as a systemic vasculitis characterized by the involvement of multiple organs such as orogenital ulcers, eye lesions including uveitis and optic neuritis, and skin lesions including folliculitis and erythema nodosum. Vascular involvement occurs occasionally and is classified into thrombosis and aneurysm. However, massive gastrointestinal bleeding from arterial aneurysm is a rare manifestation of intestinal Behcet's disease. Recently, we experienced a case of intestinal Behcet's disease presenting with massive gastrointestinal bleeding due to aneurysmal rupture of ileo-colic artery. A 30-year-old male with Behcet's disease was admitted because of massive gastrointestinal bleeding. A large ileo-cecal ulcer was revealed as a bleeding focus on colonoscopic examination. Celiac angiography showed aneurysm and stenosis of ileo-colic artery. After the failure of hemostasis with arterial embolization, ileocecectomy was performed. After the resection hematochezia was completely stopped.
Adult
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Aneurysm, Ruptured/complications/*diagnosis
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Behcet Syndrome/complications/*diagnosis
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Cecum/*blood supply/pathology/surgery
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Celiac Artery/radiography
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Colonoscopy
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Gastrointestinal Hemorrhage/*diagnosis/etiology
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Humans
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Ileum/*blood supply/pathology/surgery
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Male
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Tomography, X-Ray Computed