Small Bowel Lymphangioma

Case description

Abstract: Lymphangiomas are uncommon benign tumors found mainly in children. Intra-abdominal lymphangiomas are rare, mostly located in the mesentery. Small bowel lymphangiomas are very rare.

Patient and methods
A 38-year-old woman presented with recurrent melena and anemia. Bidirectional endoscopy was non-diagnostic. Balloon enteroscopy revealed a 1 cm actively oozing, soft, friable, polypoid lesion in the proximal-mid small bowel. The lesion was white-yellow with "strawberry" mucosal patterns. Endoscopic tattooing was performed and she underwent subsequent laparoscopic segmental small bowel resection.

Results
Histopathologic features were consistent with a cavernous lymphangioma. At last follow-up, the patient's gastrointestinal (GI) bleeding and anemia had resolved.

Conclusions
Small bowel lymphangiomas can cause gross or occult GI bleeding, anemia, abdominal pain, and/or obstruction. Endoscopists should be aware of this rare tumor and its unique endoscopic features. The optimal treatment is radical excision, since incomplete resection may lead to recurrence. Argon plasma coagulation or polypectomy have been used to achieve endoscopic ablation and palliation of GI bleeding.


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Keywords
Small bowel; Lymphangioma; Endoscopy; Gastrointestinal bleeding; Balloon enteroscopy; Video

tags: small bowel endoscopy lymphangioma

Editor

Stanisław Rządkowski

MD