SMALL BOWEL TUMOR COMPLICATED WITH BLEEDING

Abstract

Gastro-intestinal bleeding in abdominal emergency surgery is one of the difficult problems, mainly when the reason and localization of bleeding site is unknown.  More difficult is when the bleeding is from small bowel (5-10% of all GI bleedings). The difficulty is  determined by fact, that evaluation of small bowel by endoscopy is impossible and therefore it is named as “dark continent of the GI tract”. In majority  of cases the diagnosis of bleeding from small bowel is made intraoperatively.  We describe one case of bleeding from small bowel: 81year- old man, who admitted to our emergency department because of profuse GI bleeding. Endoscopic evaluation didn’t reveal any reason of bleeding, therefore patient was operated urgently. During the operation small bowel tumor complicated with bleeding has been  found. Small bowel resection with primary anastomosis performed. Patient was discharged on 5^th postoperative day without complications.   Histology revealed neuro-endocrine carcinoma. According to the literature the reason of GI bleeding is unknown in 5% of cases. Therefore we should suspect small bowel, as bleeding site, even if patient has ulcer in stomach or duodenum which doesn’t bleed.