Deutsche medizinische Wochenschrift (1946) · 2019
[Rare cause of gastrointestinal bleeding].
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Rollandi Ludovica-Paola, Kasper Judith, Schaller Tina
Аннотация
HISTOLOGY AND CLINICAL FINDINGS: We report on a 66-year-old-patient with plasmocytoma, who presented with melena since 3 days, dyspnea and dizzyness.
INVESTIGATION AND DIAGNOSIS: Because of the laboratory and clinical examination the suspected diagnosis was an active gastrointestinal bleeding. The performed gastroduodenoscopy and sigmoidoscopy could not verify an active bleeding. Thus a contrast-enhanced computed tomography was performed additionally and showed abnormal enhancement as well as a ballooning of the proximal jejunum. Subsequently a jejunoscopy was performed where an actively bleeding mass was found.
TREATMENT AND COURSE: Due to the known medical history of a plasmocytoma and in conjunction with the performed examinations the suspected diagnosis of an extramedullary metastasis of a plasmocytoma in the jejunum was made. Since only temporary control of the bleeding could be achieved, a segmental resection of the small bowel was performed. The following histological examination confirmed the diagnosis.
CONCLUSION: The differential diagnosis for gastrointestinal bleeding includes also rarely neoplastic manifestations in the small bowel. Contrast-enhanced computed tomography can aide in the localization of the bleeding side and determination of the cause of hemorrhage.
INVESTIGATION AND DIAGNOSIS: Because of the laboratory and clinical examination the suspected diagnosis was an active gastrointestinal bleeding. The performed gastroduodenoscopy and sigmoidoscopy could not verify an active bleeding. Thus a contrast-enhanced computed tomography was performed additionally and showed abnormal enhancement as well as a ballooning of the proximal jejunum. Subsequently a jejunoscopy was performed where an actively bleeding mass was found.
TREATMENT AND COURSE: Due to the known medical history of a plasmocytoma and in conjunction with the performed examinations the suspected diagnosis of an extramedullary metastasis of a plasmocytoma in the jejunum was made. Since only temporary control of the bleeding could be achieved, a segmental resection of the small bowel was performed. The following histological examination confirmed the diagnosis.
CONCLUSION: The differential diagnosis for gastrointestinal bleeding includes also rarely neoplastic manifestations in the small bowel. Contrast-enhanced computed tomography can aide in the localization of the bleeding side and determination of the cause of hemorrhage.