Endoscopic mucosal resection by double-balloon enteroscopy can be an alternative in small bowel venous malformations.

Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital disease, characterized by the presence of multiple venous malformations in the skin, gastrointestinal tract and other organs. Small bowel (SB) complications are intussusception, volvulation, and small bowel bleeding (SBB).1 Surgery may be limited by the multiplicity of lesions, morbidity, and need for intraoperative endoscopy.2 Although close follow up is mandatory because of the risk of recurrence, endoscopy may be an alternative.3 A 21‐year‐old woman diagnosed with BRBNS presented at Cabueñes University Hospital with iron deficiency anemia (hemoglobin: 6 g/dL) and continuous transfusion requirements. Three venous malformations located in the stomach and colon were treated by conventional endoscopy. SBB was suspected because of persistent iron deficiency anemia. Therefore, capsule endoscopy was carried out, detecting three polypoid angiomatous lesions in the middle jejunum. Four soft, sessile venous malformations of 1–2 cm were confirmed by oral double‐balloon enteroscopy (DBE) under general anesthesia (Fig. 1)