Lymphangioma of the Small Intestine with Chronic Gastrointestinal Bleeding

Kim, Chel Joong; Yun, Hae Ran; Choi, Min Gew; Noh, Jae Hyung; Sohn, Tae Sung; Kim, Sung

Abstract

A lymphangioma of the small bowel is a rare benign tumor of the lymphatic system, which generally is non-symptomatic but can develop some complications such as gastrointestinal obstruction or bleeding. A 40-year-old female was admitted to our hospital due to chronic gastrointestinal bleeding of 17 months duration. Endoscopic evaluation, computed tomographic examination of the abdomen and pelvis, angiography and enteroclysis were performed, but no abnormal findings were found. A red blood cell (RBC) scan demonstrated the presence of active bleeding in the upper abdominal area; however, the precise location of the bleeding could not be determined. An exploratory laparotomy was performed, with an approximately 0.4 cm sized polypoid mass detected in the proximal jejunum just distal to the Treitz ligament on an intraoperative endoscopic examination through the incision in the mid-jejunum. A segmental resection of the jejunum containing the bleeding mass and primary anastomosis was performed. The final pathological diagnosis was a lymphangioma of the jejunum. In patients with a non-localized bleeding lesion in the small intestine, an intraoperative endoscopic examination could be a useful diagnostic method.