Small Intestinal Cavernous Hemangioma Presenting with Recurrent Gastrointestinal Bleeding: A Case Report and Narrative Review.
Ya-Lin Liu, Hai-Rui Shang, Liang-Bi Xu et al.
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Case in brief
A 74-year-old female experienced recurrent melena for five months, with initial imaging failing to identify a bleeding source. Balloon-assisted enteroscopy revealed a 0.6 cm mucosal protrusion with active bleeding, which was managed with metal clip occlusion and sclerotherapy. A biopsy confirmed a cavernous hemangioma. After recurrence, surgical resection was performed, and the patient remained free from gastrointestinal bleeding at two-year follow-up.
Diagnostic / clinical pearl
Balloon-assisted enteroscopy is valuable for localizing obscure small intestinal bleeding and can facilitate both diagnosis and temporary hemostasis.
Why it matters
This case underscores the importance of surgical resection as the definitive treatment for cavernous hemangiomas, despite the initial success of endoscopic interventions.