Submucosal hematoma producing mechanical obstruction in the sigmoid colon, complicated by systemic amyloidosis

A case of systemic amyloidosis involving the gastrointestinal tract is presented. The initial manifestation of this case was mechanical obstruction. On laparotomy, a submucosal hematoma of the sigmoid colon which completely obliterated the lumen, was found. With intense medical treatment, the obstructed lumen became patent, but segmental ischemic colitis ensued. The terminal course of this case was complicated by chronic renal failure, upper gastrointestinal bleeding and coagulopathy. Pathological examination of the stomal specimen revealed massive amyloid deposits in the wall of the large intestine as well as other vital organs.