Case report: life-threatening haematochezia from a jejunal leiomyoma.
Leiomyoma is a common benign intestinal tumour. Melaena is not rare in this tumour. Recently, rectal haematochezia has been considered as one of the very rare manifestations of leiomyoma. We report a case of jejunal leiomyoma showing life-threatening rectal bleeding. This 76-year-old man was admitted to hospital because of continuous rectal bleeding for 2 days. Haemorrhagic shock occurred and transfusion of 27 units of packed red blood cells failed to correct the shock. Emergent superior mesenteric angiography revealed a distal jejunal tumour showing evidence of active oozing. Segmental intestinal resection was performed to remove this jejunal tumour. Final pathological examination disclosed a jejunal leiomyoma with a ruptured artery responsible for the life-threatening bleeding. The patient recovered after tumour resection. Our presenting case was probably the second case of jejunal leiomyoma showing haematochezia. The diagnostic priority is discussed.
Chen
C Y
CY
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Lu
C L
CL
Lo
S S
SS
Yu
I T
IT
Chang
F Y
FY
Lee
S D
SD
D000368:Aged; D000792:Angiography; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007580:Jejunal Neoplasms / Q000098:blood supply / Q000150:complications* / Q000601:surgery; D007889:Leiomyoma / Q000098:blood supply / Q000150:complications* / Q000601:surgery; D008297:Male; D008551:Melena / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D012422:Rupture, Spontaneous; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000601:surgery