Open AccessArteriovenous Malformations in Proximal Part of Ileum: A Case Report
Author(s) -
Saad Saeed,
Sidra Naz,
Ajmal Iqbal,
Maryam Irfan,
Shahab Khan,
Vikash Jaiswal,
Asmita Neupane
Publication year - 2021
Publication title -
journal of nepal medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 19
eISSN - 1815-672X
pISSN - 0028-2715
DOI - 10.31729/jnma.6929
Subject(s) - medicine , melena , hematochezia , ileum , enteroscopy , colonoscopy , laparotomy , gastrointestinal bleeding , segmental resection , gastroenterology , anastomosis , radiology , surgery , endoscopy , resection , colorectal cancer , cancer
Arteriovenous malformations in the ileum are a rare cause of gastrointestinal bleeding in young adults with few reported cases and pose difficulty in diagnosing. They usually present with chronic gastrointestinal bleed. A 30-year-old woman presented with an acute episode of hematochezia with a history of intermittent melena for 1.5 years. Complete blood count revealed a low hemoglobin level of 3.5g/dl and hypochromic microcytic anemia. Oesophago-gastro-duodenoscopy was normal; however, a colonoscopy revealed the terminal ileum and colon filled with blood. Computed tomography-Angiogram showed local intraluminal contrast extravasation in the ileum. Explorative laparotomy and on-table enteroscopy were performed identifying a small elevated, pigmented, and eroded mucosa (5 to 6 mm) in proximal ileum; resection and primary anastomosis were performed. The patient was followed after surgical resection and her symptoms improved dramatically with no additional episodes of melena and with the normalization of hemoglobin.