A Case of Bleeding Jejunal Leiomyoma Preoperatively Diagnosed by Enteroscopy

Lee, Myung Ah; Park, Soo Heon; Kim, Ji Hoon; Lee, Tae Gyu; Kim, Chang Hwan; Mun, Jin Seong; Choi, Hwang; Kim, Jae Kwang; Jung, Kyu Won; Sun, Hee Sik; Park, Doo Ho

Abstract

Lower GI bleeding occurs less frquently than upper GI bleeding. Most of the lower GI bleeding is from the colon, with 15-20% of all episodes involving the small intestine. These episodes stop spontaneously in 80% of all cases, but bleeding is recurrent in 25% of these patients. The most common cause of small intestinal bleeding is angiodysplasia, and the next is benign tumors. More than 50% of benign lesions of the small intestine remain asymptomatic and are discovered during an autopsy. Diagnosis of small intestinal lesions is not easy because of nonspecific symptoms and anatomical specificity. For instance, a 47-year-old woman was admitted to us with a 2-day history of melena. A small bowel enema revealed a filling defect at the level of 20 cm below the ligament of the Treiz. An enteroscopy revealed an ovoid elevated lesion with a central black spot and an ulceration in the proximal jejunum. An enteroscopic biopsy revealed leiomyoma. A jejunal mass was excised through a segmental resection. Pathological diagnosis of the resected mass revealed the same leiomyoma.