Unusual presentation of more common disease/injury: Successful resection of complicated bleeding arteriovenous malformation of the jejunum in patients starting dual-antiplatelet therapy just after implanting a drug-eluting coronary stent

摘要

We report a case of a 57-year-old man who started dual-antiplatelet therapy with aspirin and clopidogrel following implantation of drug-eluting coronary stent and developed persistent active gastrointestinal bleeding. After detecting the origin of bleeding by double-balloon enteroscopy, successful laparoscopy-assisted partial jejunal resection was performed and the patient condition was promptly recovered, without any thrombotic or bleeding complications. Pathology revealed arteriovenous malformation of the jejunum without any malignancy. We should care for and be aware of this lesion as a rare cause of gastrointestinal bleeding when strong antithrombotic therapy is initiated. Under rigorous assessment and perioperative management, as well as meticulous intraoperative dissection and haemostasis, satisfactory outcome was achieved even in this complicated situation.