BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often ...BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often presents as obscure gastrointestinal bleeding.It is rarely diagnosed correctly before the operation.Endoscopic injection sclerotherapy is usually used as a management of bleeding in esophageal varices and was occasionally reported as a treatment of vascular malformation.The treatment of small intestinal hemolymphangioma with enteroscopic injection sclerotherapy has not been reported.CASE SUMMARY A 42-year-old male complained of recurrent episodes of melena and dizziness,fatigue and reduced exercise capacity for more than 2 mo.Gastroduodenoscopy and blood test revealed a gastric ulcer and anemia.Treatment with oral protonpump inhibitors and iron did not improve symptoms.We then performed a capsule endoscopy and anterograde balloon-assisted enteroscopy and revealed a hemolymphangioma.Considering it is a benign tumor without malignant potential,we performed enteroscopic injection sclerotherapy.He was discharged 4 days later.At follow-up 3 mo later,the melena disappeared.Balloon-assisted enteroscopy revealed an atrophied tumor atrophied and no bleeding.Argon plasma coagulation was applied to the surface of the hemolymphangioma to accelerated healing.When he returned for follow-up 1 year later,anemia was resolved and the tumor had been cured.CONCLUSION Balloon-assisted enteroscopy and capsule endoscopy are effective methods for diagnosis of hemolymphangioma.Enteroscopic injection sclerotherapy is an effective treatment.展开更多
BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intesti...BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine,medical equipment limitations,and the lack of relevant experience among endoscopists.CASE SUMMARY Two patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloonassisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas.The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas,with a complete resection rate of 100%(4/4),without intraoperative or postoperative bleeding,perforation,or other complications.After 3-6 mo of postoperative follow-up,the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.CONCLUSION Balloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.展开更多
文摘BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often presents as obscure gastrointestinal bleeding.It is rarely diagnosed correctly before the operation.Endoscopic injection sclerotherapy is usually used as a management of bleeding in esophageal varices and was occasionally reported as a treatment of vascular malformation.The treatment of small intestinal hemolymphangioma with enteroscopic injection sclerotherapy has not been reported.CASE SUMMARY A 42-year-old male complained of recurrent episodes of melena and dizziness,fatigue and reduced exercise capacity for more than 2 mo.Gastroduodenoscopy and blood test revealed a gastric ulcer and anemia.Treatment with oral protonpump inhibitors and iron did not improve symptoms.We then performed a capsule endoscopy and anterograde balloon-assisted enteroscopy and revealed a hemolymphangioma.Considering it is a benign tumor without malignant potential,we performed enteroscopic injection sclerotherapy.He was discharged 4 days later.At follow-up 3 mo later,the melena disappeared.Balloon-assisted enteroscopy revealed an atrophied tumor atrophied and no bleeding.Argon plasma coagulation was applied to the surface of the hemolymphangioma to accelerated healing.When he returned for follow-up 1 year later,anemia was resolved and the tumor had been cured.CONCLUSION Balloon-assisted enteroscopy and capsule endoscopy are effective methods for diagnosis of hemolymphangioma.Enteroscopic injection sclerotherapy is an effective treatment.
文摘BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine,medical equipment limitations,and the lack of relevant experience among endoscopists.CASE SUMMARY Two patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloonassisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas.The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas,with a complete resection rate of 100%(4/4),without intraoperative or postoperative bleeding,perforation,or other complications.After 3-6 mo of postoperative follow-up,the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.CONCLUSION Balloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.