An uncommon cause of lower gastrointestinal bleeding: a case report

BACKGROUND: This report calls attention to severe gastrointestinal hemorrhage as a manifestation of small bowel carcinod tumor. PATIENT: We report a case of an adult in his 5th decade presenting with massive melena. INTERVENTIONS: On presentation the patient was tachycardic (pulse115/min), and hypotensive (BP 80/55 mmHg). His complete physical examination was unremarkable. Rectal exam showed frank blood. Nasogastric lavage produced greenish fluid with no blood. His hemoglobin was 8.1 gm/dl and hematocrit was 25.1%. Panendoscopy revealed an ileal bleeding mass. Interestingly a colonoscopy done 6 months earlier for anemia workup was normal. Emergent laparotomy revealed numerous smaller intraluminal nodules scattered throughout the small bowel. RESULTS: Histopathology revealed carcinoid tumor.