PMC9857476_01
Gastrointestinal venous ectasias demonstrated by capsule endoscopy in 2011 (red circle).
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F1
Initial video capsule endoscopy (VCE) in 2010 was negative, but subsequent overt bleeding event led to VCE in 2011 with findings of multiple dilated venous anomalies most notably in the ileum (Figure 1).
Active bleeding in the mid-small bowel demonstrated by capsule endoscopy at the 04:12:15 mark time in 2020.
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F2
Balloon-assisted deep enteroscopy was nondiagnostic from the anterograde approach, but VCE in April 2020 when presenting with hemoglobin 3.5 g/dL showed active bleeding in the mid-small bowel (Figure 2).
Graph illustrating the hemoglobin level from 2017 to 2022 with illustration of tranexamic acid initiation and dosing.
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F3
Subsequently, she has not required hospital admission for GI bleeding or anemia over the ensuing 21 months, and hemoglobin has shown a sustained normalization from the previous low baseline (Figure 3).