title: Blue rubber bleb nevus: an uncommon cause of intestinal intussusception.
abstract: The blue rubber bleb nevus syndrome or Bean syndrome is a rare disorder characterized by cutaneous and gastrointestinal vascular malformations. A 5-year-old girl with Bean syndrome hospitalized in a pediatric unit came under our observation with abdominal pain and vomiting. An X-ray of the abdomen showed an intestinal occlusion and an ultrasonography showed a suspected intestinal invagination. She underwent emergency laparoscopic surgery using three trocars. Laparoscopy revealed a huge ascitis and multiple vascular lesions located on the loops and on the parietal peritoneum, and we identified also an ileo-ileal invagination. We performed a laparoscopic disinvagination that showed one huge vascular lesion producing the invagination and causing a stenosis of intestinal lumen. We performed an intestinal resection after exteriorizing the loops through the umbilicus as well as a termino-terminal ileal anastomosis.
  
  
  CONCLUSIONS
  Our case shows that an intestinal invagination due to Bean syndrome is extremely rare in pediatric patients but possible. In the emergency, laparoscopy seems to be a safe and effective procedure to confirm the diagnosis and to perform the disinvagination mini-invasivally. In addition, laparoscopy permits to have a clear picture of other intra-abdominal lesions linked to Bean syndrome.
authors.affiliation: Department of Pediatrics, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy. ciroespo@unina.it
authors.forename: C
authors.initials: C
authors.lastname: Esposito
authors.forename: I
authors.initials: I
authors.lastname: Giurin
authors.forename: A
authors.initials: A
authors.lastname: Farina
authors.forename: G
authors.initials: G
authors.lastname: Ascione
authors.forename: E
authors.initials: E
authors.lastname: Miele
authors.forename: A
authors.initials: A
authors.lastname: Staiano
authors.forename: V
authors.initials: V
authors.lastname: Di Benedetto
authors.forename: A
authors.initials: A
authors.lastname: Settimi
mesh_terms: D002675:Child, Preschool; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000209:etiology; D007443:Intussusception / Q000175:diagnosis* / Q000209:etiology; D018329:Nevus, Blue / Q000150:complications*; D012878:Skin Neoplasms / Q000150:complications*