Multiple Vascular Lesions in the Gastrointestinal Tract: A Case of Blue Bleb Venous Nevus Syndrome

Blue Bleb Venous Nevus Syndrome is a rare condition characterized by multiple venous malformations in the skin and visceral organs. The small intestine is the most common site of gastrointestinal involvement; however, lesions can occur anywhere from the mouth to the anus, with the most common symptoms being bleeding and secondary anemia. Endoscopy is the most important diagnostic tool for identifying gastrointestinal lesions, showing vascular lesions with red or purplish coloration. We present the case of a 74-year-old male patient with atrial fibrillation who, after starting treatment with edoxaban, developed episodes of melena and secondary anemia. Upon physical examination, a small purplish mass resembling a blister with a vascular appearance was noted on the lower lip. An endoscopic study, including gastroscopy and colonoscopy, revealed only angiodysplasias in the second duodenal portion. Capsule endoscopy showed multiple elevated purplish lesions suggestive of venous angiomas, ranging from 5-10 mm, along the distal duodenum and proximal jejunum. These findings were confirmed by enteroscopy, which showed multiple, blue-colored venous angiomas along the duodenum and jejunum. Given the cutaneous lesions and endoscopic findings, the diagnosis was made as Blue Bleb Venous Nevus Syndrome. It is crucial to recognize this syndrome in cases of gastrointestinal bleeding of uncertain origin, as early identification through endoscopy allows for a precise diagnosis and prevents complications, ultimately improving the patient's prognosis [1] [2] [3] [4] [5].

Publication History

Article published online:
27 March 2025

• References

• 1 Lybecker MB, Stawowy M, Clausen N.. Blue rubber bleb nevus syndrome: a rare cause of chronic occult blood loss and iron deficiency anemia BMJ Case Reports. 2016; 2016:. doi:10.1136/bcr-2016-216963 PMID: 27999128; PMCID: PMC5174816.
• 2 Gawlikowska-Sroka A, Glura B, Mokrzycka M, Ociepa T.. Bean Syndrome (blue rubber bleb nevus syndrome). Pomeranian Journal of Life Sciences 2016; 62 (2): 5-7 Polish 29537205
• 3 Mayba JN, Cullingham K.. Blue rubber bleb nevus syndrome CMAJ. 2019; 191 (30) doi:10.1503/cmaj.19017331358599PMC6663495.
• 4 Lasso Andrade FA, Cadena Arteaga JA, Echeverry Morillo VL, Fajardo Arteaga ÁM, Jurado Pantoja JA, Lasso Anacona MZZ. et al. Blue rubber bleb nevus syndrome: Presentation of a case and review of the literature. Radiology Case Reports 2021; 16 (8): 2003-2006
• 5 Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY.. Blue rubber bleb nevus syndrome: a case report and literature review. World Journal of Gastroenterology 2014; 20 (45): 17254-9 PMID: 25493043; PMCID: PMC4258599