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The value of double balloon enteroscopy in diagnosing blue rubber bleb naevus syndrome: a case report.

O'Kelly F, Lim KT, Ravi N, Mahmud N, Reynolds JV - Cases J (2010)

Bottom Line: These may be difficult to diagnose, and have classically been described using computed tomographic studies and/or mesenteric angiography.Resected surgical specimens of these lesions, especially in the small bowel, have often been extensive and poorly localized.The recent advent and progressive development of double balloon enteroscopy has allowed the direct visualization and marking of these enteric lesions and serves as a valuable adjunct not only in diagnosis but also planning prior to surgery to allow accurate estimate of the extent of resection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Surgery, Trinity Centre, St James's Hospital, Dublin 8, Ireland.

ABSTRACT
Blue rubber bleb naevus syndrome is a rare vascular disorder associated with multiple gastrointestinal haemangiomas that have the potential for life-threatening haemorrhage. These may be difficult to diagnose, and have classically been described using computed tomographic studies and/or mesenteric angiography. Resected surgical specimens of these lesions, especially in the small bowel, have often been extensive and poorly localized. The recent advent and progressive development of double balloon enteroscopy has allowed the direct visualization and marking of these enteric lesions and serves as a valuable adjunct not only in diagnosis but also planning prior to surgery to allow accurate estimate of the extent of resection.

No MeSH data available.


Related in: MedlinePlus

CT mesenteric angiogram demonstrating normal enhancement of intra-abdominal vessels with no active bleeding points but evidence of small vascular anomalies.
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Figure 2: CT mesenteric angiogram demonstrating normal enhancement of intra-abdominal vessels with no active bleeding points but evidence of small vascular anomalies.

Mentions: A 58-year-old female, Irish, Caucasian patient presented, on a background history of chronic anaemia, with fatigue, palpitations, dyspnoea and haemoglobin of 5.4 g/dL. She had received intermittent blood transfusions during the previous three years. Oesophagogastroduodenoscopy and colonoscopy were normal. She was positive for occult blood. Computed tomography (CT) enteroclysis was performed which demonstrated nodular thickening of the distal jejunum (Figure 1). CT mesenteric angiogram demonstrated multiple subcentimeter hyperenhancing foci identified throughout the jejunum with normal enhancement of the aorta and mesenteric vessels (Figure 2). The patient underwent antegrade double-balloon enteroscopy (DBE) and multiple hypervascular polypoid lesions were found resembling bunches of grapes and extending over a section of 30-40 cm in the mid-jejunum (Figure 3). The distal margin of this segment was tattood.


The value of double balloon enteroscopy in diagnosing blue rubber bleb naevus syndrome: a case report.

O'Kelly F, Lim KT, Ravi N, Mahmud N, Reynolds JV - Cases J (2010)

CT mesenteric angiogram demonstrating normal enhancement of intra-abdominal vessels with no active bleeding points but evidence of small vascular anomalies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2821306&req=5

Figure 2: CT mesenteric angiogram demonstrating normal enhancement of intra-abdominal vessels with no active bleeding points but evidence of small vascular anomalies.
Mentions: A 58-year-old female, Irish, Caucasian patient presented, on a background history of chronic anaemia, with fatigue, palpitations, dyspnoea and haemoglobin of 5.4 g/dL. She had received intermittent blood transfusions during the previous three years. Oesophagogastroduodenoscopy and colonoscopy were normal. She was positive for occult blood. Computed tomography (CT) enteroclysis was performed which demonstrated nodular thickening of the distal jejunum (Figure 1). CT mesenteric angiogram demonstrated multiple subcentimeter hyperenhancing foci identified throughout the jejunum with normal enhancement of the aorta and mesenteric vessels (Figure 2). The patient underwent antegrade double-balloon enteroscopy (DBE) and multiple hypervascular polypoid lesions were found resembling bunches of grapes and extending over a section of 30-40 cm in the mid-jejunum (Figure 3). The distal margin of this segment was tattood.

Bottom Line: These may be difficult to diagnose, and have classically been described using computed tomographic studies and/or mesenteric angiography.Resected surgical specimens of these lesions, especially in the small bowel, have often been extensive and poorly localized.The recent advent and progressive development of double balloon enteroscopy has allowed the direct visualization and marking of these enteric lesions and serves as a valuable adjunct not only in diagnosis but also planning prior to surgery to allow accurate estimate of the extent of resection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Surgery, Trinity Centre, St James's Hospital, Dublin 8, Ireland.

ABSTRACT
Blue rubber bleb naevus syndrome is a rare vascular disorder associated with multiple gastrointestinal haemangiomas that have the potential for life-threatening haemorrhage. These may be difficult to diagnose, and have classically been described using computed tomographic studies and/or mesenteric angiography. Resected surgical specimens of these lesions, especially in the small bowel, have often been extensive and poorly localized. The recent advent and progressive development of double balloon enteroscopy has allowed the direct visualization and marking of these enteric lesions and serves as a valuable adjunct not only in diagnosis but also planning prior to surgery to allow accurate estimate of the extent of resection.

No MeSH data available.


Related in: MedlinePlus