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