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Hemorrhage from Leiomyomas of the Gastrointestinal Tract: A Clinical Picture Simulating Bleeding Peptic Ulcer with a Report of Six Cases

Hemorrhage from Leiomyomas of the Gastrointestinal Tract: A Clinical Picture Simulating Bleeding... Abstract Although the tendency for smooth muscle tumors of the gastrointestinal tract to bleed massively is well known, certain features deserve reemphasis. Benign tumors as small as 2 cm. in diameter are sometimes associated with repeated episodes of exsanguinating hemorrhage over a period of months or years. Rarely, fatal gastrointestinal hemorrhage occurs and the diagnosis is made only at the autopsy table.1,3 A confusing clinical picture results when these repeatedly bleeding leiomyomas are otherwise asymptomatic, cannot be demonstrated by x-ray, and are not palpable through the abdominal wall. Frequently, hemorrhage stops spontaneously after hospitalization, bed rest, and transfusions. In these cases the diagnosis is often mistaken for recurrently bleeding peptic ulcer. Many such patients have been treated with a medical peptic ulcer regimen for long periods prior to correct diagnosis. Between acute episodes of bleeding, patients may be apparently healthy and have no anemia or occult blood loss. Report of References 1. Hanno, H. A., and Mensch, M.: Leiomyoma of the Jejunum , Ann. Surg. 120:199-206, 1944.Crossref 2. Borrie, J.: Leiomyoma of Terminal Ileum , Brit. J. Surg. 37:235-237, 1949.Crossref 3. Smith, O. N.: Leiomyoma of the Small Intestine , Am. J.M. Sc. 194:700-707, 1937.Crossref 4. Silber, W.: Leiomyoma of the Jejunum with Case Reports , South African M.J. 26:25-28, 1952. 5. Golden, T., and Stout, A. P.: Smooth Muscle Tumors of the Small Bowel , Surg. Gynec. & Obst. 73:784-810, 1941. 6. Ackerman, L. V., and del Regato, J. A.: Cancer: Diagnosis, Treatment and Prognosis , St. Louis, The C. V. Mosby Company, 1947. 7. Straus, F. H., and O'Kane, C. R.: Leiomyoma of the Duodenum: Case Report and Review of the Literature , Surgery 32:869-873, 1952. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Hemorrhage from Leiomyomas of the Gastrointestinal Tract: A Clinical Picture Simulating Bleeding Peptic Ulcer with a Report of Six Cases

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1960.03820020085013
Publisher site
See Article on Publisher Site

Abstract

Abstract Although the tendency for smooth muscle tumors of the gastrointestinal tract to bleed massively is well known, certain features deserve reemphasis. Benign tumors as small as 2 cm. in diameter are sometimes associated with repeated episodes of exsanguinating hemorrhage over a period of months or years. Rarely, fatal gastrointestinal hemorrhage occurs and the diagnosis is made only at the autopsy table.1,3 A confusing clinical picture results when these repeatedly bleeding leiomyomas are otherwise asymptomatic, cannot be demonstrated by x-ray, and are not palpable through the abdominal wall. Frequently, hemorrhage stops spontaneously after hospitalization, bed rest, and transfusions. In these cases the diagnosis is often mistaken for recurrently bleeding peptic ulcer. Many such patients have been treated with a medical peptic ulcer regimen for long periods prior to correct diagnosis. Between acute episodes of bleeding, patients may be apparently healthy and have no anemia or occult blood loss. Report of References 1. Hanno, H. A., and Mensch, M.: Leiomyoma of the Jejunum , Ann. Surg. 120:199-206, 1944.Crossref 2. Borrie, J.: Leiomyoma of Terminal Ileum , Brit. J. Surg. 37:235-237, 1949.Crossref 3. Smith, O. N.: Leiomyoma of the Small Intestine , Am. J.M. Sc. 194:700-707, 1937.Crossref 4. Silber, W.: Leiomyoma of the Jejunum with Case Reports , South African M.J. 26:25-28, 1952. 5. Golden, T., and Stout, A. P.: Smooth Muscle Tumors of the Small Bowel , Surg. Gynec. & Obst. 73:784-810, 1941. 6. Ackerman, L. V., and del Regato, J. A.: Cancer: Diagnosis, Treatment and Prognosis , St. Louis, The C. V. Mosby Company, 1947. 7. Straus, F. H., and O'Kane, C. R.: Leiomyoma of the Duodenum: Case Report and Review of the Literature , Surgery 32:869-873, 1952.

Journal

Archives of Internal Medicine – American Medical Association

Published: Aug 1, 1960

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