A 19-year-old male who had been followed up in the Department of Pediatrics since she was 5 years old for iron deficiency anemia.
Gastroscopy, gastrointestinal transit and scintigraphy were performed to rule out Meckel's diverticulum, all of which were negative.
He had been asymptomatic all these years receiving treatment with oral iron.
The patient was admitted to our service for follow-up and study.
Initial diagnostic tests (gastroscopy, gastrointestinal transit), but failed to reach the diagnosis, were repeated.
Abdominal CT was performed with the objective of thickening the walls with ileum and homogeneous enhancement of the wall of about 8 cm in length.
The findings suggest as a first possibility a chronic inflammatory bowel disease type Crohn's disease, but intestinal lymphoma cannot be ruled out.
The patient refused capsule endoscopy, so empirical treatment with 5-ASA and intravenous iron was initiated.
He was admitted to the hospital two months later due to severe anemia (hemoglobin 4.8 g/dl), secondary to episodes of melena, accepting this time to perform capsule endoscopy.
The study showed a large submucosal polypoid lesion of violet color in an area that seemed to correspond to the proximal ileum, occluding half of the ileal circumference and appearing to summarize blood from that area.
A vascularized, purpura tumor measuring 10 cm in length was removed and histologically diagnosed as giant hemangioma of the small intestine.
The patient was discharged five days after surgery, subsequently asymptomatic, with normal blood tests since then.
