Gut 2007;56:12
EDITOR'S QUIZ: GI SNAPSHOT
An unusual cause of obscure gastrointestinal bleeding
1 Department of Gastroenterology, Changhua Christian Medical Center, Changhua, Taiwan, ROC
2 Department of Pathology, Changhua Christian Medical Center, Changhua, Taiwan, ROC
Correspondence to:
Dr Y-Y Chen
Changhua Christian Medical Center, 135 Nanhsiao Street, Changhua 500, Taiwan, ROC; 27716@cch.org.tw
| The first 150 words of the full text of this article appear below. |
A 69-year-old man was admitted to our institution because of a 1-week history of intermittent passage of tarry stools. His medical history was remarkable for uraemia, with regular dialysis for 5 years. He had not received non-steroidal anti-inflammatory drugs or anticoagulants. Four months previously, he had been admitted to our institution because of tarry stool passage. Prior endoscopic examination, including colonoscopy and upper gastrointestinal endoscopy, had disclosed some shallow gastric ulcers. The patient received proton pump inhibitor therapy and had not experienced further bleeding episodes during this period. Physical examination was unremarkable, except for a pale conjunctiva. Laboratory examination revealed anaemia (7.5 g/dl and mean corpuscular volume 95 fl) and normal coagulation profiles. Repeated upper endoscopy and colonoscopy did not reveal any bleeding. Double-balloon enteroscopy was performed to evaluate the bleeding.
A polyp (approximately 1 cm in size) was found in the jejunum, with shallow ulceration on its surface (fig
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