PMC8463248_01
Images from the capsule endoscopy as it progressed through the GI tract display characteristic blue rubber blebs. These vascular ectasias are suggestive of cavernous hemangiomas and AVM. The lesions appear most frequently in the duodenum and gradually decrease in size and density in the distal small bowel.
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fig1
Capsule endoscopy was then conducted, confirming vascular ectasias with superficial dilated venules/capillaries, located throughout the small bowel, as seen in Figure 1.
Interventional radiology completed angiography of the celiac (a), superior mesenteric (b), and inferior mesenteric (c) during arterial embolization. 300 to 500 micron PVA particles were used to embolize an AVM in the midjejunum.
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fig2
Ultimately, embolization of multiple arterial structures, shown in Figure 2, was performed but was unsuccessful in controlling the bleeding.