Case ReportVascular malformations of the small intestine manifesting as chronic anemia: Two pediatric cases managed by single-site umbilical laparoscopic surgery

•Vascular malformation of gastrointestinal tract manifested as a chronic anemia due to obscure gastrointestinal bleeding in girls.•Vascular malformation of the small intestine in pediatric patient is uncommon finding.•Despite of limitations of diagnosis, a selective angiography and CT enterogram with angiography was helpful to diagnose.•Successfully managed two cases of vascular malformation identified at jejunum by a single-site umbilical laparoscopic surgery.

IntroductionVascular malformations affecting abdominal viscera, especially the gastrointestinal tract, are less common than that in other body segments. Nonetheless, it seems to be one of the important causes of gastrointestinal bleeding in not only adults but also children as well. It occurs during the development stage of vascular system, and may increase in severity as the child grows.Presentation of caseWe present here two cases of lesions developed at the small intestine in an 8-year-old girl and 3-year-old girl, which were identified during the management for chronic anemia. Although there were some limitations associated with diagnosis, a histology confirmed the presence of arteriovenous malformations in both cases, they were successfully treated with surgical resection, especially minimal invasive procedure.DiscussionVascular malformations of abdominal viscera, especially the small intestine, are rare clinical manifestations in pediatric patients but are among the important causes of acute massive or chronic obscure LGI bleeding. Unless there is significant GI bleeding, patients are usually treated for anemia with obscure LGI bleeding. In the present study, selective angiography was useful in one case and CT enterogram with angiography was useful in the other case.ConclusionConsidering the rarity and possibility of gastrointestinal bleeding due to vascular malformations, it is necessary to be regarded as one of differential diagnosis when managing a lower gastrointestinal bleeding in pediatric patients. Besides, a minimal invasive procedure could be suggested as a good surgical option when necessary.