Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

OBJECTIVETo investigate the diagnostic value and safety of single-balloon electronic enteroscopy in children with small intestinal bleeding.

METHODSSeventy children with clinically suspected small intestinal bleeding, including 38 males and 32 females aged 4-13 years, underwent single-balloon enteroscopy under general anesthesia. Twenty-six cases underwent the procedure through the mouth, 32 cases through the anus, and 12 cases through both.

RESULTSOf the 70 children, 58 (83%) had small bowel disease according to the single-balloon enteroscopy results, including 24 cases of non-specific inflammation, 12 cases of allergic purpura, 8 cases of Crohn's disease, 8 cases of Meckel's diverticulum, and 6 cases of Peutz-Jeghers syndrome.

CONCLUSIONSSingle-balloon enteroscopy is a safe, effective means for the diagnosis of small intestinal bleeding among children.

Adolescent ; Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; methods ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Humans ; Intestine, Small ; pathology ; Male

Adolescent ; Adult ; Aged ; Child ; Endoscopy, Gastrointestinal ; methods ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; pathology ; Humans ; Male ; Middle Aged

Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.
Adult ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Intestinal Polyps/diagnosis/*pathology ; Jejunal Diseases/diagnosis/*pathology ; Male

Meckel diverticulum (MD), a congenital gastrointestinal anomaly, is often involved in pediatrics, but less in the adult population. The patient in this report was a 69-year-old female presented with massive gastrointestinal bleeding causing hemorrhagic shock due to MD containing ectopic pancreatic tissue. A review of the literature revealed that gastrointestinal bleeding from MD containing ectopic pancreatic tissue is rare in adults and difficult to be identified preoperation. MD should be considered as one of the differential diagnosis for lower gastrointestinal bleeding, although scarce in adults, especially when the patient has massive painless bleeding.
Aged ; Choristoma ; diagnosis ; physiopathology ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Humans ; Meckel Diverticulum ; diagnosis ; physiopathology ; Pancreas ; pathology

Jejunal diverticula is a rare disease and an unusual cause of obscure gastrointestinal hemorrhage. Obscure gasterointestinal bleeding is difficult to treat because the bleeding site cannot be identified by routine endoscopy and contrast studies. A wireless capsule endoscopy is not invasive and can visualize the entire small bowel. However, this method has limitations of incapability of taking biopsies and performing endoscopic interventions such as polypectomy or stent insertion. The double-balloon enteroscopy is being used frequently for the diagnosis and management of various small bowel diseases. We report a case of proximal jejunal diverticular bleeding diagnosed by double-balloon enteroscopy and treated with angiographic embolization.
Colonoscopy/*methods ; Diagnosis, Differential ; *Diverticulum ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Jejunal Diseases/*pathology ; Middle Aged

We report a case of rectum telangiectasia, a rare form of lower gastrointestinal hemorrhage caused by vascular malformation. The patient underwent laparoscopic assisted abdomino-perineal resection of the sigmoid colon-rectum telangiectasia. The extent and degree of pathological changes were observed directly from the intestinal wall during laparoscopic surgery, and after collection of biopsy evidence, concomitant definitive surgery was performed to achieve a minimally invasive effect.
Gastrointestinal Hemorrhage ; diagnosis ; therapy ; Humans ; Laparoscopy ; Rectum ; pathology ; Telangiectasis ; diagnosis ; therapy

Dieulafoy's lesion is an uncommon cause of gastrointestinal bleeding. Hemorrhage occurs through mucosal erosion from an abnormally dilated submucosal artery. Although Dieulafoy's lesion is usually located in the stomach, it may occur anywhere in the gastrointestinal tract. We report here on a case of jejunal Dieulafoy's lesion presenting as a mass and short segment stricture on CT and enteroclysis.
Adult ; Arteriovenous Malformations/*pathology ; Diagnosis, Differential ; Gastrointestinal Hemorrhage/*pathology ; Humans ; Jejunal Diseases/*pathology ; Jejunum/blood supply/pathology ; Male

There have been several published reports on metastatic lesions in the stomach, but the number of cases have been limited due to the low frequency of the condition. Metastatic lesions in the stomach are usually asymptomatic. A 55-year-old man with known metastatic lung adenocancer exhibited epigastric pain, hematemesis, and melena. A bleeding, ulcerated gastric metastasis was found and treated with endoscopic therapy and omeprazole.
Neoplasm Metastasis ; Middle Aged ; Male ; Lung Neoplasms/*complications/*diagnosis ; Humans ; Gastrointestinal Tract/*pathology ; Gastrointestinal Hemorrhage/diagnosis/*pathology ; Fatal Outcome ; Cell Nucleus/metabolism ; Adenocarcinoma/pathology ; Acute Disease

A 51-year-old man visited the tertiary-care hospital with a 2-week history of dizziness and dyspnea on exertion. The initial hemoglobin level was 5.8 g/dL, without any history of hematochezia or melena. The esophagogastroduodenoscopy (EGD) was normal. During colonoscopic preparation, the patient experienced hematochezia and became hypotensive. On angiography, no extravasation of contrast media was observed. A CT scan with angiography showed a small high-density area in the jejunal lumen, suggesting extravasation of the contrast media. Capsule endoscopy was performed, and oozing bleeding was suspected in the proximal to mid jejunum. The patient was referred to our hospital. Repeated EGD and CT enterography did not reveal any significant bleeding. An antegrade double balloon endoscopy was performed, and an approximately 2-cm-sized submucosal tumor with ulceration and a non-bleeding exposed vessel was observed in the mid jejunum. The presumed diagnosis was jejunal gastrointestinal stromal tumor. The mass was surgically resected, and the final histopathological diagnosis was arteriovenous malformation.
Arteriovenous Malformations/*diagnosis/pathology ; Capsule Endoscopy ; Diagnosis, Differential ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors/diagnosis ; Humans ; Jejunum/*pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed