Endoscopic resection of small bowel lymphangiomas: A case series

Aims The authors present 3 cases of successful endoscopic resection of small bowel lymphangiomas after a full evaluation of anaemia.

Methods A 29-year-old woman with no relevant past medical history was admitted with severe symptomatic anaemia (haemoglobin 2.9g/dL) and no visible blood loss. During admission, she performed upper endoscopy and colonoscopy which were normal. Small bowel capsule endoscopy (SBCE) identified a friable and whitish sessile lesion and for that reason she underwent a push enteroscopy. The lesion was identified in the proximal jejunum with around 12mm. En-bloc endoscopic mucosal resection (EMR) was performed.

Results A 72-year-old man underwent SBCE during admission due to iron deficiency anaemia (4.7g/dL). SBCE identified an oozing bleeding from unknown origin. A double balloon enteroscopy identified a sessile lesion with around 9mm, in the proximal jejunum, and oozing bleeding. En-bloc EMR was performed. A 63-year-old man underwent SBCE due to iron deficiency anaemia (9.6g/dL) identifying a 10mm sessile lesion in the distal duodenum and fresh blood. Push enteroscopy reached the lesion and en-bloc EMR was performed.

Conclusions Prophylactic clipping of the mucosal defect was performed in all cases and no complications were reported. Normal haemoglobin levels were reached during follow-up. All histopathological analysis revealed a lymphangioma. This is an uncommon benign tumour with rare involvement of the small bowel that can justify occult and overt gastrointestinal bleeding. Complete resection is the optimal treatment although only a few cases of endoscopic resection are reported.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023