Spring 2014 – Leiomyosarcoma of Small Bowel Discovered by Double Balloon Enteroscopy: a Case Report

Leiomyosarcoma of Small Bowel Discovered by Double Balloon Enteroscopy: a Case Report

Authors: Malika Gill*, Shabana F. Pasha, Matthew A, Zarka

Author Affiliations:
Royal College of Surgeons Ireland, Dublin, Ireland

Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, AZ, USA

Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, AZ, USA

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Corresponding Author: Malika Gill; malikagill[at]rcsi.ie

Key Words: leiomyosarcoma; double balloon eneroscopy; small bowel tumors; balloon-assisted enteroscopy; deep enteroscopy; capsule endoscopy.

Abstract: Introduction and Patient Profile: Introduction of deep enteroscopy (capsule endoscopy (CE), balloon-assisted enteroscopy, and spiral enteroscopy) has led to a significant improvement in diagnosis and management of obscure gastrointestinal bleeding (OGIB). Small bowel (SB) lesions are traditionally discovered by CE or double balloon enteroscopy (DBE). Leiomyosarcomas are rare SB tumors and must be diagnosed early to prevent the risk of metastasis and to improve prognosis. A 46-year-old previously healthy woman presented with 3 weeks of abdominal pain and OGIB. Interventions and Outcomes: Patient underwent usual endoscopic modalities in identifying the source of her gastrointestinal bleeding. Computerized tomography scan identified intussusception of the SB; however, conventional endoscopy and CE were negative for etiology of source of bleeding. Ultimately, DBE successfully located the site of gastrointestinal bleeding, confirmed by pathology as a leiomyosarcoma of the SB. Discussion: Conventional endoscopy and CE may miss some lesions, while DBE can navigate altered SB anatomy, take biopsies, and even provide therapy to the lesion. Although double balloon enteroscopies are expensive and require longer sedation than average endoscopic modalities, they may provide another tool for the diagnosis of SB lesions when other modalities are unsuccessful.

Published on date: May 31, 2014

Senior Editor: Sahil Bobby Gambhir

Junior Editor: Tina Chaalan

DOI: Pending

Citation: Gill M, Pasha SF, Zarka MA. Leiomyosarcoma of Small Bowel Discovered by Double Balloon Enteroscopy: a Case Report. Medical Student Research Journal. 2014;3(Spring):51-4.

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Jessica Wummel

Executive Editor
Jessica Wummel is a third year medical student at Michigan State University’s College of Human Medicine. She received her B.S. in Human Biology with a specialization in Bioethics, Humanities, and Society also from Michigan State University in 2011 from the Lyman Briggs College. She is interested in pursuing a career in Med/Peds and would eventually like to be involved in academic medicine later in her career.