title: Epigastraglia with tarry stools in a middle-aged female caused by jejunal intussusception due to a hamartoma.
abstract: Upper gastrointestinal (GI) hemorrhage is a common presentation to an emergency department. Often, the diagnosis is peptic ulcer disease in which vague or sharp abdominal pain is associated with bleeding. In contrast, intussusception is a rare cause of abdominal pain and coincident GI bleeding. In this case, we report a 41-year-old woman who had an intussuscepting jejunal obstruction due to a hamartoma of the small bowel. The diagnosis was established by ultrasonography. In review of the literature, abdominal pain and bleeding are two common manifestations of intussusception when the lesion originates in the small bowel. Intussusception is frequently included in the differential diagnosis of pediatric patients with coincident abdominal pain and bleeding. However, it is rarely mentioned as an adult cause of these two findings. Because of the delayed and nonspecific presentations of abdominal discomfort in adult patients with intussusception, the diagnosis is often delayed. This case points out the need for considering intussusception even in middle-aged patients whose initial presentation is concomitant bleeding and pain.
authors.affiliation: Emergency Department, Veterans General Hospital-Taipei, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: Shu-Ping
authors.initials: SP
authors.lastname: Tung
authors.forename: Chii-Hwa
authors.initials: CH
authors.lastname: Chern
authors.forename: Jen-Der
authors.initials: JD
authors.lastname: Chen
authors.forename: Chorng-Kuang
authors.initials: CK
authors.lastname: How
authors.forename: Hsin-Chin
authors.initials: HC
authors.lastname: Shih
authors.forename: Lee-Min
authors.initials: LM
authors.lastname: Wang
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Huang
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D005243:Feces; D005260:Female; D005734:Gangrene / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006222:Hamartoma / Q000150:complications*; D006801:Humans; D007417:Intestinal Polyps / Q000150:complications*; D007443:Intussusception / Q000209:etiology*; D007579:Jejunal Diseases; D014839:Vomiting / Q000209:etiology