Massive gastrointestinal hemorrhage from AIDS-related Kaposi's sarcoma confined to the small bowel managed with radiation

A > 50% incidence of Kaposi's sarcoma (KS) of the gastrointestinal tract has been seen in acquired immunodeficiency syndrome (AIDS) patients with cutaneous KS. Although gastrointestinal Kaposi's sarcoma (GIKS) is usually asymptomatic, hemorrhages from the oral cavity, esophagus, stomach, and large bowel have occurred in this disease. We describe a patient with acute, massive gastrointestinal hemorrhage from GIKS confined to the small bowel who was treated with chemotherapy, surgery, and radiation. To the best of our knowledge, this is the first reported case of AIDS-related GIKS limited to the small bowel. Although chemotherapy is generally used successfully to palliate diffuse GIKS, we report that radiation was an effective modality that rapidly resulted in resolution of considerable local bleeding and could be used in such cases as an alternative to surgery. Details of this case history, including radiographs, are presented.