Gastrointestinal hemorrhage--an unusual manifestation of neurofibromatosis

Hemorrhage from intestinal neurofibromas or leiomyomas is an infrequent but often life-threatening complication of neurofibromatosis. Despite typical cutaneous findings, the bleeding tumor usually cannot be demonstrated because of its inaccessible location in the jejunum or ileum. In the present case, superior mesenteric arteriography successfully demonstrated hemorrhage from a jejunal leiomyoma. Review of the literature demonstrates the difficulty of establishing the correct diagnosis by other means. Arteriography should be the contrast procedure of first choice in the patient with neurofibromatosis and gastrointestinal bleeding.