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An uncommon cause of lower gastrointestinal bleeding: a case report
1Department of Internal Medicine, University of Tennessee, College of Medicine, Chattanooga, 960 East Third Street, Suite 208, TN 37403, USA. gduttaa@yahoo.com.
Background:
This report calls attention to severe gastrointestinal hemorrhage as a manifestation of small bowel carcinod tumor.
Patient:
We report a case of an adult in his 5th decade presenting with massive melena.
Interventions:
On presentation the patient was tachycardic (pulse115/min), and hypotensive (BP 80/55 mmHg). His complete physical examination was unremarkable. Rectal exam showed frank blood. Nasogastric lavage produced greenish fluid with no blood. His hemoglobin was 8.1 gm/dl and hematocrit was 25.1%. Panendoscopy revealed an ileal bleeding mass. Interestingly a colonoscopy done 6 months earlier for anemia workup was normal. Emergent laparotomy revealed numerous smaller intraluminal nodules scattered throughout the small bowel.
Results:
Histopathology revealed carcinoid tumor.
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