Brunner's gland hamartomas are rare tumors of duodenum, they are often discovered incidentally during esophagogastroduodenoscopy or upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal hemorrhage and intestinal obstruction. Most of Brunner's gland hamartomas are located within the range of the standard esophagogastroduodenoscope. However, they are rarely located below the third portion of duodenum. As well known, the small intestine, including the 4th portion of duodenum, jejunum, and ileum, is relatively inaccessible with routine endoscopy. Thus, the diagnosis of Brunner's gland hamartoma in these area can be delayed up to several months after onset of symptoms. We report a case of Brunner's gland hamartoma which was located in the fourth portion of the duodenum and presented as obscure gastrointestinal hemorrhage. Radiologic, surgical, and pathologic appearances are presented.
Brunner Glands ; Duodenal Diseases/*complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/*etiology ; Hamartoma/*complications/diagnosis ; Humans ; Middle Aged

Amyloidosis is a disorder characterized by extracellular deposition of amyloid in various tissues and organs. Gastrointestinal manifestations including gastroparesis, constipation, malabsorption, intestinal pseudo-obstruction, and bleeding are common. GI bleeding is a rare initial symptom which can be fatal in some cases. Absence of systemic symptoms and nonspecific endoscopic findings in amyloidosis may make diagnosis difficult. Therefore, amyloidosis-induced GI bleeding should be considered in patients with an obscure hemorrhage. Recently, we experienced a 65-year-old woman who presented with massive hematochezia as a manifestations of amyloidosis. Colonoscopy and SMA angiography showed massive bleeding in the small and large intestine. Colonoscopic biopsy established amyloidosis. We report this case with a review of the relevant literatures.
Aged ; Amyloidosis/*complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Intestinal Diseases/*complications/diagnosis

The majority of patients with scleroderma have gastrointestinal involvement, and a few experience gastrointestinal hemorrhage, however, gastrointestinal hemorrhage due to Mallory-Weiss syndrome is very rare. We report upon a 24-year-old pregnant woman with scleroderma who had gastrointestinal hemorrhage due to Mallory-Weiss syndrome.
Adult ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Human ; Mallory-Weiss Syndrome/*diagnosis/*etiology ; Pregnancy ; Pregnancy Complications/*diagnosis ; Scleroderma, Systemic/*complications

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

The clinical manifestations of intestinal tuberculosis are non-specific. But, abdominal pain, low grade fever, weight loss, anorexia, and diarrhea are major symptoms of intestinal tuberculosis. Massive bleeding has been reported as a rare manifestation of intestinal tuberculosis. Massive hematochezia from intestinal tuberculosis has rarely been reported in the medical literature. Also, most of them were treated with anti-tuberculosis medication only or with surgery. We treated a case of intestinal tuberculosis presenting massive hematochezia with colonoscopic coagulation therapy and anti-tuberculosis medication. Here, we report a Korean man who presented with massive hematochezia from ileal tuberculosis and treated by endoscopic coagulation therapy.
Adult ; English Abstract ; Gastrointestinal Hemorrhage/*etiology/therapy ; *Hemostasis, Endoscopic ; Humans ; Ileal Diseases/*complications/diagnosis ; Male ; Tuberculosis, Gastrointestinal/*complications/diagnosis

Adult ; Crohn Disease ; complications ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Hemoperitoneum ; diagnosis ; etiology ; Humans ; Wounds, Nonpenetrating ; diagnosis ; etiology

BACKGROUND/AIMS: Little information is available on the rate and predictive factors of rebleeding of unknown cause, which is very important in deciding further investigations on obscure-overt gastrointestinal bleeding. The aim of this study was to evaluate the rebleeding rate and related factors in obscure-overt gastrointestinal bleeding patients who revealed normal gastroscopic and colonoscopic findings. METHODS: A total of 69 patients with negative first-line gastroscopy and colonoscopy were enrolled in this study as obscure-overt gastrointestinal bleeding cases. The relationships between rebleeding and clinical characteristics were analyzed retrospectively. RESULTS: The causes of obscure-overt gastrointestinal bleeding were confirmed in 30 cases among the 69 cases. Small bowel tumors (14 cases) were the most common cause, followed by vascular lesions (6 cases). The mean follow-up period was 28 months and rebleeding was noticed in 19 patients (27.5%). Among these rebleeding patients, 14 cases (73.7%) occurred within 6 months. The past experience of previous bleeding was significantly related with rebleeding (p=0.0009). CONCLUSIONS: Close observation and detailed investigations are needed for obscure-overt gastrointestinal bleeding patients with bleeding history, especially during 6 months follow-up.
Adult ; Aged ; Angiodysplasia/complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Gastrointestinal Neoplasms/complications/diagnosis ; Humans ; Intestinal Diseases/complications/diagnosis ; Male ; Middle Aged ; Recurrence ; Risk Factors

The stomach is the most frequent site of gastrointestinal stromal tumor (GIST). The common clinical manifestation of GIST are melena and hematochezia caused by gastointestinal bleeding. However, hemoperitoneum due to GIST rupture is a very rare condition. We describe a 33-year-old man with gastric GIST causing hemoperitoneum. A preoperative CT scan demonstrated large amount of fluid collection and extraluminal mass lesion in gastric antral area. He underwent an emergent laparotomy. The antral mass was polypoid shaped and showed ruptured focus. We performed a distal gastrectomy. The tumor was revealed as GIST with intermediate malignant risk by pathologic examination. The patient had an uneventful postoperative course and remains well.
Adult ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors/complications/*diagnosis/surgery ; Hemoperitoneum/*diagnosis/etiology ; Humans ; Male ; Tomography, X-Ray Computed

Meckel's diverticulum is an embryonic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract. Its incidence records about 2%. Among them, only 5% are symptomatic with complications-bleeding, intestinal obstruction, inflammation, and perforation. In particular, bleeding is a common complication and has always been caused by an ulceration of the ileal mucosa adjacent to the acid-producing ectopic mucosa in a Meckel's diverticulum. Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. We experienced a case of Meckel's diverticulum detected by wireless capsule endoscopy in a 34 year-old man who presented with chronic obscure gastrointestinal bleeding.
Adult ; Chronic Disease ; *Endoscopy, Gastrointestinal ; English Abstract ; Gastrointestinal Hemorrhage/*diagnosis/*etiology ; Humans ; Male ; Meckel Diverticulum/*complications/diagnosis

Gastrointestinal leiomyomas are commonly found in the stomach, and but 3% of them arises from the colon. Colonic leiomyomas are often found incidentally during colonoscopic examination. Most of patients with colonic leiomyoma are asymptomatic, but patients with large size leiomyoma occasionally have abdominal mass, hemorrhage, intestinal obstruction or perforation. Pedunculated leiomyomatous polyp is rare. Leiomyomatous polyps are occasionally misjudged as adenomatous polyps by endoscopist. We report a case of pedunculated leiomyomatous colonic polyp in 65 year-old female patient. She has complained of intermittent hematochezia and lower abdominal discomfort for 5 months. During colonoscopy, an 1 cm sized long pedunculated polyp at the splenic flexure was detected. It was removed by colonoscopic snare polypectomy. Leiomyomatous polyp was confirmed by microscopic and immunohistochemical findings.
Aged ; Anus ; Colonic Neoplasms/complications/*diagnosis ; *Colonoscopy ; English Abstract ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; *Leiomyoma/complications/*diagnosis