Surgical considerations for spinal epidural hematoma evacuation in the setting of blue rubber bleb nevus syndrome in a child

"The Blue Rubber Bleb Nevus Syndrome: A Delayed Diagnosis Made Possible by Video-Capsule Endoscopy. Case Report and Review of the Literature"

“…Isoldi et al reported that most patients in their series of 18 BRBNS became transfusion-dependent during pediatric age with a mean diagnostic delay (presentation to diagnosis) of 2.2 years [46]. This case and the literature review support the idea that pediatric patients with suspected BRBNS should be investigated by upper and lower GI endoscopy, including VCE [16,[45][46][47]. VCE may produce a kind of "map" that detects digestive lesions beyond the stomach and enables their clear definition and localization.…”

“…Additionally, GI lesions are more prone to underhand symptoms leading to diagnostic delays. Medical treatment with Sirolimus seems promising, especially when other therapies would be too aggressive or fail [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. In our case, a "dominant lesion" was detected at birth, as it generally happens, but it was resected before the diagnostic definition.…”