Clin Endosc.  2014 Nov;47(6):575-578. 10.5946/ce.2014.47.6.575.

Polypoid Arteriovenous Malformation Presenting with Jejunojejunal Intussusceptions in an Adult

• Lim DH
• Ahn JY
• Seo M
• Yun JH
• Kim TH
• Jung HY
• Kim JH
• Park YS

• KMID: 2134499
• DOI: http://doi.org/10.5946/ce.2014.47.6.575

Abstract

Jejunal polypoid arteriovenous malformations (AVMs) and jejunojejunal intussusceptions are both rare. Here, we present the case of a 61-year-old woman who suffered intermittent episodes of abdominal pain over the course of 13 years. A computed tomography scan of her abdomen and pelvis revealed a distal jejunojejunal intussusception. A suspected low density mass was observed at the tip of the intussusception. Treatment comprised laparoscopic small bowel resection with end-to-end jejunostomy. The final diagnosis was a polypoid AVM measuring 5x3.5x3 cm. We suggest that polypoid AVM should be considered as a differential diagnosis in patients presenting with small intestinal neoplasms.

Keyword

Abdominal pain; Arteriovenous malformations; Jejunum; Intussusception; Polypoid arteriovenous malformation

MeSH Terms

Abdomen
Abdominal Pain
Adult*
Arteriovenous Malformations*
Diagnosis
Diagnosis, Differential
Female
Humans
Intestinal Neoplasms
Intussusception*
Jejunostomy
Jejunum
Middle Aged
Pelvis

Figure

• 

  Fig. 1 (A, B) An abdominopelvic computed tomography scan showing a long segmental small bowel intussusception with a suspected low density mass at the tip (arrowheads).

• 

  Fig. 2 (A, B) Macroscopic appearance of the specimen after segmental resection. A well-defined, polypoid mass can be seen in the small intestinal mucosa.

• 

  Fig. 3 Microscopic appearance of the polypoid mass. Dilated tortuous vessels and vein wall thickenings can be seen in the submucosa (H&E stain, ×100).

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