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Case Reports
. 2018 Nov 27;18(1):371.
doi: 10.1186/s12887-018-1339-9.

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

Jiande Chen  1 , Bin Zhang  2 , Zhilong Yan  3 , Huaying Zhao  3 , Kaihua Yang  2 , Yong Yin  4 , Lirong Jiang  5
Affiliations
Case Reports

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

Jiande Chen et al. BMC Pediatr. .

Abstract

Background: The diagnosis of obscure gastrointestinal bleeding (OGIB) which is defined as bleeding of unknown origin of the small bowel by routine evaluation in childhood is a challenge.

Case presentation: Here we report a one-year-old Chinese girl who was suspected with idiopathic pulmonary haemosiderosis (IPH) and referred to our department for further diagnosis. Finally she was diagnosed with vascular malformations (VM) by exploratory laparoscopy combined with pathological examination.

Conclusions: Children OGIB could be easily misdiagnosed in the beginning, and OGIB children with active ongoing bleeding may benefit from proceeding directly to exploratory laparoscopy, followed by pathological confirmation of the diagnosis.

Keywords: Iron-deficiency anemia; Melena; Vascular malformations.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethics Committee of Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine and was conducted in accordance with the Declaration of Helsinki.

Consent for publication

Written informed consent was obtained from the parent for the publication of this case report.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Chest CT. Increased patch density in the left lower lobe (a) and the right upper lobe (b) of the lung
Fig. 2
Fig. 2
Lesion within the wall of jejunum. A 3 cm lesion with dense blistered protrusions on the surface within the wall of jejunum
Fig. 3
Fig. 3
Gross view and microscopic features of intestinal wall VM. Macroscopically, there was a lesion with dense blistered protrusions on the surface within the intestinal wall (a). On microscopy, abnormal collections of dilated vascular structures of variable sizes were observed in the lesion (b, original magnification × 10)
See this image and copyright information in PMC

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References

    1. Raju GS, Gerson L, Das A, Lewis B. American gastroenterological association (AGA) institute technical review on obscure gastrointestinal bleeding. Gastroenterology. 2007;133(5):1697–1717. doi: 10.1053/j.gastro.2007.06.007. - DOI - PubMed
    1. American Gastroenterological Association medical position statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000;118(1):197–201. - PubMed
    1. Romano C, Oliva S, Martellossi S, Miele E, Arrigo S, Graziani MG, Cardile S, Gaiani F, de'Angelis GL, Torroni F. Pediatric gastrointestinal bleeding: perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol. 2017;23(8):1328–1337. doi: 10.3748/wjg.v23.i8.1328. - DOI - PMC - PubMed
    1. Kimpton JA, Bowen JC, Craigie RJ. Paediatric angiodysplasia of the jejunum: a case report and review of the literature. Scott Med J. 2012;57(4):247. doi: 10.1258/smj.2012.012082. - DOI - PubMed
    1. Kim SH, Cho YH, Kim HY. Vascular malformations of the small intestine manifesting as chronic anemia: two pediatric cases managed by single-site umbilical laparoscopic surgery. Int J Surg Case Rep. 2017;31:233–236. doi: 10.1016/j.ijscr.2017.01.057. - DOI - PMC - PubMed

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