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Rare case of small intestine bleeding.
Jeremy D Cumberledge1, Ikenna Anaka1, Justin T Kupec1
1Department of Medicine, Section of Digestive Diseases, West Virginia University Hospitals, Morgantown, West Virginia, USA.
BMJ Case Reports
|February 1, 2019
Summary
A rare duodenal adenocarcinoma was diagnosed in a healthy woman presenting with bleeding and iron deficiency anemia. Surgical resection achieved negative margins, classifying it as stage II disease.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Small bowel bleeding and iron deficiency anemia can be challenging to diagnose.
- Capsule endoscopy is a valuable tool for evaluating obscure gastrointestinal bleeding.
Observation:
- A 59-year-old woman presented with melaena and iron deficiency anemia.
- Capsule endoscopy revealed an ulcerated, bleeding lesion in the duodenum.
- Push enteroscopy identified an ulcerated mass, confirmed as adenocarcinoma on biopsy.
Findings:
- The patient was diagnosed with stage II duodenal adenocarcinoma (T3N0) after surgical resection.
- No distant metastasis was detected on computed tomography.
- Surgical pathology confirmed a resected mass with negative lymph nodes.
Implications:
- Duodenal adenocarcinoma, though rare, is a significant cause of small bowel bleeding.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
- This case highlights the importance of advanced endoscopic techniques in diagnosing duodenal malignancies.
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