Diagnostic and Therapeutic Benefits of Intra-operative Enteroscopy in Epithelioid Angiosarcoma of the Small Intestine

Abstract

Intestinal epithelioid angiosarcoma is an uncommon type of vascular tumor with unusually varied clinical presentations, including non-explained severe gastrointestinal bleeding, anemia, and abdominal pain. A 77-year-old man presented with recurrent severe anemia caused by gastrointestinal bleeding. The diagnosis was jejunal angiosarcoma. The patient had three intestinal resections assisted by explorative intraoperative enteroscopy, which detected multifocal intestinal lesions. Intraoperative enteroscopy is a helpful diagnostic and prognostic approach that detects small intestinal tumors. Intraoperative enteroscopy could improve the outcome of intestinal angiosarcomas.

Keywords: gastrointestinal bleeding; intestinal angiosarcoma; intestinal resection; intraoperative enteroscopy; sarcoma.

Figure 1. Video capsule shows a nonbleeding ulcerated vascular lesion of the proximal jejunum.

Figure 2. Video capsule shows a necrotic ulcerated jejunal lesion.

Figure 3. Enteroscopy showed suspected jejunal lesion

Figure 4. Enteroscopy showed (A) suspected ulcerated jejunal lesion and (B) suspected non-bleeding vascular lesion of proximal jejunum.

Figure 5. Video capsule showed an active bleeding jejunal lesion.

Figure 6. Enteroscopy showed active jejunal bleeding in an ulcerated and anastomosis zone.