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Pseudomelanosis duodeni:a case report.

Masaya Iwamuro1,2, Shohei Oka1, Hiromitsu Kanzaki1

  • 1Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.

Nihon Shokakibyo Gakkai Zasshi = the Japanese Journal of Gastro-Enterology
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PubMed
Summary

This study identified pseudomelanosis duodeni, a rare condition causing brown pigment in the small intestine, in an elderly male patient. Iron and sulfur deposits in duodenal villi confirmed the diagnosis.

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Area of Science:

  • Gastroenterology
  • Medical Diagnostics
  • Histopathology

Background:

  • Pseudomelanosis duodeni is a rare condition characterized by the deposition of a pigment in the duodenal mucosa.
  • It is often associated with conditions causing altered motility or bleeding, and certain medications.
  • This case report details a diagnosis in an elderly male patient undergoing screening endoscopy.

Observation:

  • Esophagogastroduodenoscopy revealed characteristic brownish speckled pigmentation in the duodenal bulb.
  • Biopsy of the duodenal villi showed brown pigment deposition, appearing bright under scanning electron microscopy.
  • Analysis of biopsy specimens indicated the presence of iron and sulfur.

Findings:

  • Energy dispersive X-ray spectroscopy and elemental mapping confirmed iron and sulfur deposition within the duodenal villi.
  • These findings are consistent with the pathological characteristics of pseudomelanosis duodeni.
  • The diagnosis was established based on endoscopic and histopathological evidence.

Implications:

  • This case expands the understanding of pseudomelanosis duodeni presentation and diagnostic findings.
  • Highlights the importance of comprehensive diagnostic workup, including advanced imaging and spectroscopy, for rare gastrointestinal conditions.
  • Contributes to the literature on pigment deposition disorders in the duodenum.