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Case Reports in Gastrointestinal Medicine
Volume 2012 (2012), Article ID 186065, 3 pages
http://dx.doi.org/10.1155/2012/186065
Case Report

An Unusual Endoscopic Image of a Submucosal Angiodysplasia

1Gastroenterology Department, Coimbra University Hospital, 3000-075 Coimbra, Portugal
2General Surgery Department, Coimbra University Hospital, 3000-075 Coimbra, Portugal
3Pathology Department, Coimbra University Hospital, 3000-075 Coimbra, Portugal

Received 21 April 2012; Accepted 8 August 2012

Academic Editors: D. C. Damin, E. Savarino, and C. Vogt

Copyright © 2012 Rita Carvalho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Obscure gastrointestinal bleeding is responsible for 2–10% of the cases of digestive bleeding. Angiodysplasia is the most common cause. The authors report a case of a 70-year-old female patient admitted to our Gastrointestinal Intensive Care Unit with a significant digestive bleeding. Standard upper and lower endoscopy showed no abnormalities, and we decided to perform a capsule enteroscopy that revealed a submucosal nodule with active bleeding in the jejunum. An intraoperative enteroscopy confirmed the presence of a small submucosal lesion with a central ulceration, and subsequently a segmental enterectomy was performed. Surprisingly, the histopathological diagnosis was angiodysplasia. The patient remains well after a two-year period of follow-up. We present this case of obscure/overt gastrointestinal bleeding to emphasize the role of capsule and intraoperative enteroscopy in the evaluation of these situations, and because of the unusual endoscopic appearance of the angiodysplasia responsible for the hemorrhage.