Endoscopic management of blue rubber bleb nevus syndrome in the colon with hemostatic clamp and snare.

A 24-year-old woman presented having had soft, blue nodules on the palm of her hand (▶Fig. 1), lower limbs, and feet since birth. The number and size of the lesions had increased a little as she had grown up. She had suffered repeated episodes of intermittent melena or tarry stools since the age of 10 years, which had been accompanied by symptoms of pallor, dizziness, fatigue, and anorexia. In the year before, the frequency of her episodes of hematochezia had increased and her other symptoms had worsened. Gastroscopy revealed no abnormality, but colonoscopy revealed multiple hemangiomas in the colon (▶Fig. 2 a), ranging in size from 0.3 cm to 2.0 cm. Hemostatic clamp electrocoagulation was used to treat the lesions that were less than 0.5 cm in diameter; lesions larger than 0.5 cm in diameter were resect-