title: A case of a ruptured submucosal aneurysm of the small intestine identified using double-balloon enteroscopy.
abstract: A 47-year-old woman was admitted to our hospital urgently with sudden-onset hematochezia. She was temporarily in a state of hemorrhagic shock. As we strongly suspected bleeding from the small intestine, peroral double-balloon enteroscopy was performed, and indicated a 2.0-cm diameter hemispheric elevated lesion in the jejunum. Moreover, a blood clot was observed at the top of the protrusion. The site was marked by injecting India ink, without taking a biopsy specimen, to avoid further hemorrhaging. Subsequently, laparoscopic partial small bowel resection was performed. On histopathological examination, the lesion was found to be a sac-like submucosal arterial aneurysm, with a diameter of 3.5 mm, comprising several small abnormal arteries. The final diagnosis was a ruptured submucosal aneurysm of the small intestine. Ruptured submucosal aneurysms are very rarely observed in the small intestine. Only a few reports have described their endoscopic findings. Our experience indicates that small bowel enteroscopy may be useful for managing ruptured submucosal aneurysms of the small intestine.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan. hirofumi.chiba@med.tohoku.ac.jp.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Chiba
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Endo
authors.affiliation: Department of Pathology, Tohoku University Hospital, Sendai, Japan.
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Fujishima
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohtsuka
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naitoh
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Masatake
authors.initials: M
authors.lastname: Kuroha
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shiga
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kakuta
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kinouchi
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001158:Arteries / Q000473:pathology / Q000601:surgery; D058582:Double-Balloon Enteroscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged
keywords: Double-balloon enteroscopy; Gastrointestinal hemorrhage; Ruptured submucosal aneurysms; Small intestine