Small intestinal vascular malformations

　　The etiology of small intestinal vascular malformations is unknown and may be related to acquired vascular degeneration, congenital vascular developmental abnormalities, and chronic mucosal ischemia. Boley et al. believe that the disease is a chronic, intermittent mucosal subvenous mild obstruction leading to degeneration.

　　In addition to its clinical manifestations, small intestinal vascular malformations can also cause other diseases. Patients may develop anemia due to repeated bleeding. Severe anemia can lead to anemia cardiopathy and atrophic gastritis, and the latter can further exacerbate anemia due to iron absorption disorders.

　　Small intestinal vascular malformations may not present with symptoms, and the only clinical manifestation is gastrointestinal bleeding. Generally, there is intermittent hematochezia, with moderate amounts, which may lead to anemia, symptoms such as dizziness, tinnitus, and pale complexion. In a few cases, due to large amounts of bleeding, shock may occur. The symptoms of this disease may occur continuously or intermittently.

　　Small intestinal vascular malformation can be asymptomatic, and the only clinical manifestation is gastrointestinal bleeding. In terms of prevention, attention should be paid to prenatal health care and prenatal examination. Pregnant women should avoid pregnancy-related stress and avoid drinking.

　　The auxiliary examinations for small intestinal vascular malformation mainly include the following:

　　1. X-ray

　　Routine barium meal and barium enema cannot obtain an accurate diagnosis, but they can exclude other diseases, especially gastric and duodenal ulcers.

　　2. Endoscopic Examination

　　In recent years, the application of small intestinal endoscopy can make a judgment on gastrointestinal occult bleeding in 26% to 77% of patients.

　　3. Angiography

　　It is currently believed that angiography is the most reliable method for diagnosing this disease, with a diagnostic rate of 75% to 90%.

　　Patients with small intestinal vascular malformation should choose healthy foods and beverages instead of high-fat, high-sugar, and high-calorie foods, eat more different types of vegetables and fruits, whole grains, and legumes, and reduce the intake of red meat (beef, pork, and lamb). In addition, patients should also pay attention to avoiding the consumption of processed meats and limiting the intake of high-salt foods.

　　The treatment methods for small intestinal vascular malformation include the following:

　　1. Routine Treatment

　　Routine treatment includes blood transfusion, intravenous fluid administration, maintaining water and electrolyte balance, and gastrointestinal decompression. Antishock treatment is performed in the event of shock.

　　2. Endoscopic Treatment

　　After the diagnosis is clear and the positioning is obtained, laser treatment, electrocoagulation treatment, and other methods can be chosen, but they are only suitable for vascular malformation diseases of the stomach, duodenum, or colon.

　　3. Catheter Treatment

　　Catheter treatment has a hemostatic effect, but the disadvantage is that it cannot prevent recurrence of bleeding.

　　4. Surgical Treatment

　　It is currently believed that the most effective and definite treatment method for the surgical resection of the intestinal segment with vascular malformation is the operation. The key to the operation lies in the accurate positioning before and during the operation, and not missing the segment of the intestine with the lesion.