[Complicated gastrointestinal bleeding of neoplastic diseases of the hematopoietic system].
The incidence of gastrointestinal bleeding has been reported as 10-30% of the patients with neoplastic diseases of the hematopoietic organ. The pathogenesis of gastrointestinal bleeding is multifactorial; direct leukemic cell infiltrations mucosal changes ensuing from bone marrow suppression or immunodeficiency states, infections due to various organisms, and preceding peptic ulcers. Once the diagnosis of hematopoietic neoplasm has been established, complete gastrointestinal work-up by endoscopy, CT-scanning or MRI should be mandatory. Early examination of the gastrointestinal tract has advantages of recognition of preceding peptic ulcers and their treatment, as well as providing prophylactic steps to the gastrointestinal mucosa vulnerable to hemorrhage. The prognosis of gastrointestinal bleeding complicated with hematopoietic malignancies seems to be poor due to the fact that DIC, multiorgan failures or fatal infections are seriously involved in their terminal stages.
Department of Internal Medicine, Kitakyushu City Wakamatsu Hospital.
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Yoshida
D004211:Disseminated Intravascular Coagulation / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D009102:Multiple Organ Failure / Q000150:complications; D011379:Prognosis