title: Intestinal bleeding from arteriovenous malformations of the small bowel in a patient with Cowden syndrome: report of a case.
abstract: This report presents the case of a patient with Cowden syndrome who had arteriovenous malformations (AVMs) at the jejunum and the ileum and experienced intestinal bleeding. A 54-year-old Japanese male presented with general fatigue and melena. Endoscopic examinations showed gastrointestinal polyposis from the esophagus to the rectum. However, the site of bleeding was not identified. There were some papules on his face and neck. He also had macrocephaly and had multiple papillomas along the gum-line. These findings indicated a clinical diagnosis of Cowden syndrome. Enhanced computed tomography (CT) and angiography analyses indicated the presence of AVMs at the jejunum and the ileum. He was treated with partial resection of the jejunum and ileum including these two AVMs. This was a rare case of two AVMs involving the small bowel in a patient with Cowden syndrome. Enhanced CT was very useful and convenient for the detection of gastrointestinal AVMs in this case.
authors.affiliation: Department of Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kita-kyushu 807-8555, Japan. nakayama@med.uoeh-u.ac.jp
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Jun
authors.initials: J
authors.lastname: Segawa
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Sujita
authors.forename: Noritaka
authors.initials: N
authors.lastname: Minagawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Torigoe
authors.forename: Masanori
authors.initials: M
authors.lastname: Hisaoka
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D018256:Adenomatous Polyps / Q000150:complications / Q000473:pathology; D001165:Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006223:Hamartoma Syndrome, Multiple / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007082:Ileum / Q000098:blood supply* / Q000601:surgery; D044483:Intestinal Polyposis / Q000150:complications / Q000473:pathology; D007583:Jejunum / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology; D014057:Tomography, X-Ray Computed