[Jejunal GIST with obscure gastrointestinal bleeding]

Area of Science:

• Gastroenterology
• Internal Medicine

Background:

• A case study of an elderly female patient with a history of cardiac arrhythmia and hemorrhoids.
• The patient presented with recurrent symptomatic iron deficiency anemia requiring multiple transfusions.

Observation:

• Initial endoscopic evaluations revealed only minor findings such as small diverticula and colon polyps.
• Subsequent hospitalizations for bloody stools and melena showed gastritis, colonic ulcers, and erosions.
• Despite multiple investigations, the source of bleeding remained obscure.

Findings:

• Capsule endoscopy successfully identified angiodysplasia in the jejunum as the source of obscure gastrointestinal bleeding.
• Anterograde enteroscopy visualized erythematous lesions in the proximal jejunum, consistent with angiodysplasia.

Implications:

• This case highlights the diagnostic utility of capsule endoscopy and enteroscopy in identifying obscure gastrointestinal bleeding sources in elderly patients.
• Angiodysplasia, though often found in the colon, can occur in the small intestine and present as a source of significant bleeding.