AbstractBackgroundLymphangiomas are uncommon benign tumors found mainly in children. Intra-abdominal lymphangiomas are rare, mostly located in the mesentery. Small bowel lymphangiomas are very rare.Patient and methodsA 38-year-old woman presented with recurrent melena and anemia. Bidirectional endoscopy was non-diagnostic. Balloon enteroscopy revealed a 1 cm actively oozing, soft, friable, polypoid lesion in the proximal-mid small bowel. The lesion was white-yellow with “strawberry” mucosal patterns. Endoscopic tattooing was performed and she underwent subsequent laparoscopic segmental small bowel resection.ResultsHistopathologic features were consistent with a cavernous lymphangioma. At last follow-up, the patient's gastrointestinal (GI) bleeding and anemia had resolved.ConclusionsSmall bowel lymphangiomas can cause gross or occult GI bleeding, anemia, abdominal pain, and/or obstruction. Endoscopists should be aware of this rare tumor and its unique endoscopic features. The optimal treatment is radical excision, since incomplete resection may lead to recurrence. Argon plasma coagulation or polypectomy have been used to achieve endoscopic ablation and palliation of GI bleeding.