Resection of arteriovenous malformation of the jejunum treated by laparoscopy-assisted surgery.

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  • 腹腔鏡補助下に切除した空腸動静脈奇形の１例

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Abstract

A 76-year-old woman was admitted to our hospital because of repeated bloody stool, the bleeding site not detected and anemia for 6 months. Gastroscopy, colonoscopy, and upper gastrointestinal series failed to confirm any bleeding site, so abdominal angiography was ordered. Superior mesenteric arteriography showed a dilated vein from the early arterial phase to the venous phase and small intestinal endoscopy visualized a small nodular elevation resembling a submucosal tumor in the jejunum 30cm from Treitz's ligament, leading to the diagnosis of arteriovenous malformation (AVM). We conducted laparoscopic surgery. Since the tumor lesion was not detected from the serosal side, intraoperative intestinal endoscopy was introduced and the lesion was detected from the mucosal side. The jejunum including the portion 10cm long was pulled out of the abdomen through the minilapatomy and resected. The postoperative course was good and no anal bleeding recurred. Laparoscopic surgery with the use of intestinal endoscopy is thus effective for treating intestinal AVM.

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