title: [Bleeding in digestive tract caused by jejunal angiodysplasia: complementary value of capsule endoscopy and double-balloon enteroscopy].
abstract: We report the case of a 35-year-old male patient, with a history of six months of pallor and dyspnea associated with severe iron deficiency anemia and positive fecal occult blood tests. Endoscopy of the lower and upper gastrointestinal tract, and a small bowel follow-through were performed, but did not reveal the origin of the bledding. Later, a capsule endoscopy study were performed and detected an elevated area - not well defined - with active bleeding in the jejunal portion of the small bowel, for that reason we decided to complement the study with a double balloon enteroscopy, that allowed us to see more clearly the jejunal lesion: an elevated and ulcerated lesion; the area was marked with India ink to guide the surgeon. In the surgical intervention a resection of the involved jejunal segment was performed; the study of pathological anatomy established the diagnosis of jejunal angiodysplasia. We present this case of obscure gastrointestinal bleeding to emphasize the diagnostic utility of capsule endoscopy and double balloon enteroscopy.
authors.affiliation: Departamento del Aparato Digestivo, Hospital Nacional Edgardo Rebagliati Martins EsSalud (HNERM), Lima-Perú.
authors.forename: Jorge
authors.initials: J
authors.lastname: Vásquez
authors.forename: Edgar
authors.initials: E
authors.lastname: Alva
authors.forename: Oscar
authors.initials: O
authors.lastname: Frisancho
authors.forename: Max
authors.initials: M
authors.lastname: Yoza
authors.forename: Eduardo
authors.initials: E
authors.lastname: Zumaeta
authors.forename: José
authors.initials: J
authors.lastname: Watanabe
authors.forename: Américo
authors.initials: A
authors.lastname: Palomino
mesh_terms: D000328:Adult; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D053704:Capsule Endoscopy; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal; D004867:Equipment Design; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007813:Laparotomy; D008297:Male; D009780:Occult Blood