Multiple haemangiomas of the jejunum: gastrointestinal bleeding

Case contributed by Dr Maria Grazia Papi

Presentation

Severe anaemia, dark red rectal bleeding mixed in with the stools, and abdominal pain.

Patient Data

Age: 70 years
Gender: Female

At the non contrast CT study some dense material with irregular distribution in the lumen of the small and large bowel it is visible, suggesting GI bleeding.

At the enhanced scan arterial phase , no obvious GI focal lesion is detectable.

During the portal, the venous and the delayed phase multiple  intramural pregressive enhancing lesions in the jejunum  are detectable which resulted   as histologic diagnosis  of multiple haemangiomas

Case Discussion

 

GI haemangiomas can cause GI bleeding, abdominal pain, end anaemia

Most intestinal haemangiomas are located in the jejunum arising from the submucosal vascular plexus and often form a polypoid, intraluminal subepithelial mass, although they may occasionally appear diffuse.

CT reveals   intramural subepithelial lesions with an intraluminal growth pattern. Dynamic contrast-enhanced CT images demonstrate slow diffuse enhancement, visible at the portal venous and delayed phase : accordingly with this study, these lesions could be easily missed during the arterial phase and unenhanced CT. 

In this patient previous colonoscopy and capsule endoscopy did not show clearly any GI lesion causing bleeding.

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Case information

rID: 54774
Case created: 27th Jul 2017
Last edited: 18th Sep 2017
Inclusion in quiz mode: Included

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