Saudi Journal of Gastroenterology
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Year : 2009  |  Volume : 15  |  Issue : 3  |  Page : 213-214
Bleeding per rectum in a patient with an amputated finger


Departments of Radiodiagnosis, General Surgery and Gastroenterology, SK Institute of Medical Sciences, Srinagar, Kashmir - 190 011, India

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Date of Web Publication24-Jul-2009
 

How to cite this article:
Hakeem A, Shafi H, Rasool S, Ahmad M. Bleeding per rectum in a patient with an amputated finger. Saudi J Gastroenterol 2009;15:213-4

How to cite this URL:
Hakeem A, Shafi H, Rasool S, Ahmad M. Bleeding per rectum in a patient with an amputated finger. Saudi J Gastroenterol [serial online] 2009 [cited 2019 Nov 19];15:213-4. Available from: http://www.saudijgastro.com/text.asp?2009/15/3/213/54741


A 42-year-old female who had her right index finger amputated 13 months back now presented to the department of gastroenterology with symptoms of abdominal pain and bleeding per rectum. On examination the patient had iron deficiency anemia and features of cachexia. Upper gastrointestinal (GI) endoscopy and colonoscopy were done but did not reveal any lesion. The patient underwent computed tomography (CT) scan on a Siemens 64-slice CT scanner, which showed multiple rounded, markedly enhancing, small gut (jejunal) lesions, along with an enteroenteric intussusception [Figure 1],[Figure 2],[Figure 3]. A similarly enhancing lesion was also found in the left gluteus medius muscle.


   Questions Top


  1. What is the probable close differential diagnosis?
  2. What is the appropriate diagnostic modality in such patients?
  3. What treatment should be offered to this patient?




Click here to view answer. View Answer


 
   References Top

1.Reintgen DS, Thompson W, Garbutt J, Seigler HF. Radiologic, endoscopic, and surgical considerations of melanoma metastatic to the gastrointestinal tract. Surgery 1984;95:635-9.  Back to cited text no. 1  [PUBMED]  
2.de la Monte SM, Moore GW, Hutchins GM. Patterned distribution of metastases from malignant melanoma in humans. Cancer Res 1983;43:3427-33.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Pacovsky Z, Fait V. Distant metastasis of malignant melanoma in the small intestine. Rozhl Chir 1992;71:424-8.  Back to cited text no. 3    
4.Gatsoulis N, Roukounakis N, Kafetzis I, Gasteratos S, Mavrakis G. Small bowel intussusception due to metastatic malignant melanoma. A case report. Tech Coloproctol 2004;8:s141-3.  Back to cited text no. 4    
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6.Caputy GG, Donohue JH, Goellner JR, Weaver AL. Metastatic melanoma of the gastrointestinal tract. Results of surgical management. Arch Surg 1991;126:1353-8.  Back to cited text no. 6    
7.Khadra MH, Thompson JF, Milton GW, McCarthy WH. The justification for surgical treatment of metastatic melanoma of the gastrointestinal tract. Surg Gynecol Obstet 1990;171:413-6.   Back to cited text no. 7  [PUBMED]  
8.Agrawal S, Yao TJ, Coit DG. Surgery for melanoma metastatic to the gastrointestinal tract. Ann Surg Oncol 1999;6:336-44.   Back to cited text no. 8  [PUBMED]  
9.Ollila DW, Essner R, Wanek LA, Morton DL. Surgical resection for melanoma metastatic to the gastrointestinal tract. Arch Surg 1996;131:975-9; 979-980.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]
10.Ko?odziejski L, Lobaziewicz W, Wysocki W, Metastases of the melanoma to the intestine. Wiad Lek. 2006;59:784-9.  Back to cited text no. 10    
11.Byrd BF, Morton CE, Malignant melanoma metastatic to the gastrointestinal tract from an occult primary tumor. South Med J. 1978;71:1306-8.  Back to cited text no. 11    
12.Loualidi A, Spooren PF, Grubben MJ, Blomjous CE, Goey SH. Duodenal metastasis: An uncommon cause of occult small intestinal bleeding. Neth J Med 2004;62:201-5.   Back to cited text no. 12  [PUBMED]  [FULLTEXT]
13.Wulf V, Schroder HJ. Metastasis to the small intestine of malignant melanoma as a rare cause of intestinal hemorrhage. Zentralbl Chir 1994;119:515-6.  Back to cited text no. 13    

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Correspondence Address:
Aijaz Hakeem
Department of Radiodiagnosis, SK Institute of Medical Sciences, Srinagar, Kashmir - 190 011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.54741

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