Duodenal metastasis: an uncommon cause of occult small intestinal bleeding

Duodenal metastases are a very uncommon and peculiar cause of upper gastrointestinal bleeding. However, they should be considered in a patient presenting with upper gastrointestinal bleeding and a previous history of malignancy. The importance of recognising the unusual presentation of duodenal metastasis has to be emphasised. We describe two patients with upper gastrointestinal bleeding due to duodenal metastases. In the first patient a periampullary bleeding due to a metastasis of a renal cell carcinoma was detected five years after nephrectomy of the right kidney. In the second patient an occult bleeding caused by a duodenal metastasis of a melanoma was diagnosed. The first manifestation of this melanoma was eight years earlier.