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Pseudomelanosis intestini "from pylorus to jejunum:" A rare endoscopic finding in a patient with GI bleeding
Ali Zakaria1, Backer Abdu2, Bayan Al Share2
1Department of Gastroenterology, Providence-Providence Park Hospital, Michigan State University College of Human Medicine, Southfield, Michigan, USA.
Abstract:
Pseudomelanosis of the gastrointestinal (GI) tract is a rare condition used to describe the accumulation of pigment deposits in the intestinal mucosa. Its underlying cause is not well understood. It has been described in association with gastrointestinal hemorrhage, chronic kidney disease, hypertension, diabetes mellitus, and medications such as hydralazine, ferrous sulfate, and furosemide. Melanosis coli is a well-known condition associated with the use of anthranoid laxatives; however, pseudomelanosis of the small intestine is extremely rare and most commonly described in the duodenum, with few cases in the gastric mucosa and even more rare in the jejunum. Herein, we report a case of pseudomelanosis intestini involving the pylorus, duodenum, and proximal jejunum in a patient presented with GI bleeding. The clinical significance of this condition is unknown; however, gastroenterologists should be aware of its existence.
Insights
Pseudomelanosis intestini, a rare pigment deposition in the gastrointestinal tract, is presented in a case involving the pylorus, duodenum, and jejunum. Its clinical significance remains unknown, necessitating awareness among gastroenterologists.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Pseudomelanosis of the gastrointestinal (GI) tract is a rare condition characterized by pigment deposits in the intestinal mucosa.
- The exact cause is not well understood, but it has been associated with GI hemorrhage, chronic kidney disease, hypertension, diabetes mellitus, and certain medications.
Observation:
- Melanosis coli, linked to anthranoid laxatives, is distinct from pseudomelanosis, particularly in the small intestine.
- Pseudomelanosis of the small intestine is exceptionally rare, with most cases reported in the duodenum, fewer in the gastric mucosa, and even rarer in the jejunum.
Findings:
- This report details a rare case of pseudomelanosis intestini affecting the pylorus, duodenum, and proximal jejunum.
- The patient presented with gastrointestinal bleeding, highlighting a potential association.
Implications:
- The clinical significance of pseudomelanosis intestini is currently unknown.
- Gastroenterologists and healthcare providers should be aware of this rare condition for accurate diagnosis and management.
- Further research is needed to elucidate the underlying mechanisms and clinical impact of pseudomelanosis intestini.