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Parasitic leiomyoma as a rare cause of small intestinal venous bleeding: A case report

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A 49-year-old female patient with a history of laparoscopic myomectomy five years prior presented with hematochezia that had begun two days earlier. Computed tomography (CT) revealed multiple enhancing masses in the abdomen, pelvis, and uterus, suspected to be parasitic leiomyomas. One of these masses was in contact with the adjacent ileum and demonstrated a vascular structure protruding into the ileal lumen, raising suspicion of a bleeding focus. Although transarterial angiography did not definitively demonstrate active bleeding, prophylactic embolization was performed. However, hematochezia recurred, and follow-up CT revealed signs of venous bleeding, prompting surgical resection of the tumor, including segmental resection of the small bowel. This report describes an unusual case of intraluminal venous bleeding caused by parasitic leiomyoma as a rare source of small bowel hemorrhage.

Abstract

A 49-year-old female patient with a history of laparoscopic myomectomy five years prior presented with hematochezia that had begun two days earlier. Computed tomography (CT) revealed multiple enhancing masses in the abdomen, pelvis, and uterus, suspected to be parasitic leiomyomas. One of these masses was in contact with the adjacent ileum and demonstrated a vascular structure protruding into the ileal lumen, raising suspicion of a bleeding focus. Although transarterial angiography did not definitively demonstrate active bleeding, prophylactic embolization was performed. However, hematochezia recurred, and follow-up CT revealed signs of venous bleeding, prompting surgical resection of the tumor, including segmental resection of the small bowel. This report describes an unusual case of intraluminal venous bleeding caused by parasitic leiomyoma as a rare source of small bowel hemorrhage.

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