Recurrent gastrointestinal blood loss of obscure origin: report of an exceptional case.
A 66-year old tailor was admitted because of venous insufficiency of the left lower leg. During the hospital course, recurrent severe gastrointestinal blood loss developed. A classical approach was extended by enteroscopy and radionuclide scanning, followed by exploratory laparatomy with removal of two intra-abdominal sewing needles and a jejunal leiomyoma. After surgery, bleeding did not recur. This case illustrates the difficult diagnostic work-up of obscure gastrointestinal bleeding. It also shows that intra-abdominal sewing needles may migrate in the intestinal tract and remain silent during many years, eventually causing gastrointestinal bleeding.
Samyn
I
I
Department of Internal Medicine, University Hospital AZ-VUB, Brussels, Belgium.
Reynaert
H
H
Op de Beeck
B
B
Simoens
C
C
Verbeelen
D
D
D000005:Abdomen; D000368:Aged; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007580:Jejunal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007813:Laparotomy; D007889:Leiomyoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome