title: Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy.
abstract: Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Min Seon
authors.initials: MS
authors.lastname: Park
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Beom Jae
authors.initials: BJ
authors.lastname: Lee
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Dae Hoe
authors.initials: DH
authors.lastname: Gu
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Jeung-Hui
authors.initials: JH
authors.lastname: Pyo
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Kyeong Jin
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Yun Ho
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Moon Kyung
authors.initials: MK
authors.lastname: Joo
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Jong-Jae
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Min Seon Park, Beom Jae Lee, Dae Hoe Gu, Jeung-Hui Pyo, Kyeong Jin Kim, Yun Ho Lee, Moon Kyung Joo, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospitial, Seoul 152-703, South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bak
mesh_terms: D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D002425:Cautery; D003113:Colonoscopy; D058582:Double-Balloon Enteroscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D007417:Intestinal Polyps / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008201:Lymphangiectasis, Intestinal / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
keywords: Double balloon endoscopy; Endoscopic polypectomy; Intestinal lymphangiectasia; Small bowel bleeding; Solitary ileal polypoid lesion