A Case of Non-Specific Ulcer of the Small Intestine Presenting with Massive Bleeding

Naoto Saito, Isamu Koyama, Haruyuki Anzai, Nozomu Shinozuka, Yoshitaka Suzuki, Takashi Matsumoto, Hiroshi Asano and Ryozo Omoto

First Department of Surgery, Saitama Medical School

A case of nonspecific simple ulcer of the small intestine causing massive hemorrhage is reported here. A 60-year-old man was admitted to our hospital because of melena and lower abdominal pain. After admission he fell into hypovolemic shock due to massive melena. Celiac and superior mesenteric arteriograms demonstrated no abnormalities, however, ^99mTc-RBC scintigraphy suggested bleeding from the distal ileum, and an emergency operation was performed. A small induration was palpated in the ileum 40cm proximal to the iliocecal valve, and wedge resection of the lesion was performed. A small ulcer was included in the specimen, and histopathological examination revealed a non-specific simple ulcer. In this case, a non-specific ulcer in the small intestine developed massive bleeding, and ^99mTc-RBC scintigraphy was useful for the localization of the lesion.

Key words
massive bleeding, non-specific ulcer of small intestine, ^99mTc-RBC scintigraphy

Reprint requests
Naoto Saito First Department of Surgery, Saitama Medical School 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, 350-0495 JAPAN

Accepted
September 22, 1999

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