Diffuse intestinal polypoid angiodysplasia

Excerpt

This 6-year-old boy presented with bleeding per rectum for two days. He was pale but hemodynamically stable. There were no mucocutaneous lesions. He had two similar episodes in the past treated conservatively elsewhere. Hemoglobin was 6 g/dL and other blood investigations were normal. Esophagogastroduodenoscopy, ultrasound abdomen and colonoscopy did not reveal any abnormal findings. Meckel’s isotope scan was negative. Laparoscopy assisted enteroscopy revealed diffuse bluish polypoid lesions in the jejunum with ooze in one particular segment (Fig. 1a). The oozing segment was surgically resected and end-to-end anastomosis was done (Fig. 1b). Histopathological examination showed foci of dilated, tortuous, thin-walled vascular channels and few arterial channels in the submucosa with focal extension into the mucosa and muscularis propria suggestive of angiodysplasia (Fig. 1c). Serosal involvement was not evident. He has remained asymptomatic on follow up for two years.

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