Severe gastrointestinal bleeding due to carcinoid tumour of the ileum

Repeated episodes of severe intestinal bleeding in a 55-year-old male were found to originate from multiple small carcinoid tumours of the ileum. Laparatomy was performed after extensive negative endoscopic and radiological investigation of the bleeding site, and five tumours, 6 to 15 mm in diameter, were found within a 40 cm bowel segment. The most distal tumour was situated 50 cm from the ileocaecal valve. The site of bleeding was erosion of the bowel mucosa at the largest tumour. The affected bowel was excised, including its mesentery with two lymph nodes containing small islands of metastatic carcinoid tumour. Otherwise no metastases were found.