Tumorous arteriovenous malformation in the jejunum missed by capsule endoscopy.

摘要

A 57-year-old man was admitted to our hospital with me-lena. An EGD and colonoscopy were normal; however, the patient's stools were markedly positive for occult blood. The patient underwent a capsule endoscopy (CE) examination because small-intestinal bleeding was suspected. The CE revealed oozing of blood in the jejunum (A); however, a significant lesion was not observed on the CE images. An antegrade double-balloon enteroscopy (DBE) was performed to establish the source of the bleeding, and a 2-cm freely bleeding mass was observed in the upper jejunum (B) and was subsequently resected (C). Pathologic examination of the mass revealed an arteriovenous malformation (D) (Elastica-Masson staining, orig. mag. ×4). There was no recurrent bleeding.