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Intestinal bleeding from arteriovenous malformations of the small bowel in a patient with Cowden syndrome: report of a case

Surgery Today volume 43, pages 542–546 (2013)Cite this article

Abstract

This report presents the case of a patient with Cowden syndrome who had arteriovenous malformations (AVMs) at the jejunum and the ileum and experienced intestinal bleeding. A 54-year-old Japanese male presented with general fatigue and melena. Endoscopic examinations showed gastrointestinal polyposis from the esophagus to the rectum. However, the site of bleeding was not identified. There were some papules on his face and neck. He also had macrocephaly and had multiple papillomas along the gum-line. These findings indicated a clinical diagnosis of Cowden syndrome. Enhanced computed tomography (CT) and angiography analyses indicated the presence of AVMs at the jejunum and the ileum. He was treated with partial resection of the jejunum and ileum including these two AVMs. This was a rare case of two AVMs involving the small bowel in a patient with Cowden syndrome. Enhanced CT was very useful and convenient for the detection of gastrointestinal AVMs in this case.

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Conflict of interest

Yoshifumi Nakayama and the other co-authors have no conflicts of interest to declare.

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Affiliations

  1. Department of Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kita-kyushu, 807-8555, Japan

    Yoshifumi Nakayama, Noritaka Minagawa, Takayuki Torigoe & Koji Yamaguchi

  2. Department of Gastroenterological and General Surgery, Wakamatsu Hospital of University of Occupational and Environmental Health, 1-17-1 Hamamachi, Wakamatsu-ku, Kita-kyushu, 808-0024, Japan

    Yoshifumi Nakayama

  3. Department of Cardiovascular Medicine, Hagiwara Central Hospital, 1-10-1 Hagiwara, Yahata-nishi-ku, Kita-kyushu, 806-0059, Japan

    Jun Segawa

  4. Department of Gastroenterology, Hagiwara Central Hospital, 1-10-1 Hagiwara, Yahata-nishi-ku, Kita-kyushu, 806-0059, Japan

    Kazufumi Sujita

  5. Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kita-kyushu, 807-8555, Japan

    Masanori Hisaoka

Authors
  1. Yoshifumi Nakayama
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  2. Jun Segawa
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  3. Kazufumi Sujita
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  4. Noritaka Minagawa
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  5. Takayuki Torigoe
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  6. Masanori Hisaoka
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  7. Koji Yamaguchi
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Correspondence to Yoshifumi Nakayama.

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Nakayama, Y., Segawa, J., Sujita, K. et al. Intestinal bleeding from arteriovenous malformations of the small bowel in a patient with Cowden syndrome: report of a case. Surg Today 43, 542–546 (2013). https://doi.org/10.1007/s00595-012-0460-x

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  • DOI: https://doi.org/10.1007/s00595-012-0460-x

Keywords

  • Cowden syndrome
  • Arterial venous malformations
  • Gastrointestinal bleeding
  • Gastrointestinal polyposis