Abstract
Over a 3-year period, two patients with neurofibromatosis were referred to our medical center for evaluation of repeated episodes of melena. Upper endoscopy was unrevealing in each case, as was colonoscopy. Arteriography during active hemorrhage was helpful in localizing the source of bleeding in one patient but not in the other. The source of bleeding in each patient was obvious at surgical exploration. Large neurofibromas protruded from the seorsal surface of a short region of jejunum in both cases and an additional segment of ileum in one case. Hemorrhage had occurred as a result of erosion of mucosa stretched over these tumors. Local resection of the involved segments produced long-term control of the hemorrhage. Since these tumors were grossly visible on the serosal surface of the involved intestinal segments, laparoscopic evaluation could have been used to hasten diagnosis in each case.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barkin JS, Lewis BS, Reiner DK, Waye JD, Goldberg RI, Phillips RS (1992) Diagnostic and therapeutic jejunoscopy with a new, longer enteroscope. Gastrointest Endosc 38: 55–58
Buntin PT, Fitzgerald JF (1970) Gastrointestinal neurofibromatosis: a rare cause of chronic anemia. Am J Dis Child 119: 521–523
Cosgrove JM, Fischer MG (1988) Gastrointestinal neurofibroma in a patient with von Recklinghausen's disease. Surgery 103: 701–703
Cox JGC, Royston CMS, Sutton DR (1988) Multiple smooth muscle tumours in neurofibromatosis presenting with chronic gastrointestinal bleeding. Postgrad Med J 64: 149–151
Devereux RB, Koblenz LW, Cipriano P, Gray GF (1975) Gastrointestinal hemorrhage — an unusual manifestation of neurofibromatosis. Am J Med 58: 135–138
Ghrist TD (1963) Gastrointestinal involvement in neurofibromatosis. Arch Intern Med 112: 357–362
Hochberg FH, DaSilva AB, Galdabini J, Richardson EP (1974) Gastrointestinal involvement in von Recklinghausen's neurofibromatosis. Neurology 24: 1144–1151
Iida M, Matsui T, Itoh H, Mibu R, Fujishima M (1990) The value of push-type jejunal endoscopy in familial adenomatosis coli/Gardner's syndrome. Am J Gastroenterol 85: 1346–1348
Ishizaki Y, Tada Y, Ishida T, Bandai Y, Idezuki Y, Hitoshi N, Mitio I (1992) Leiomyosarcoma of the small intestine associated with von Recklinghausen's disease: report of a case. Surgery 111: 706–710
Jeng KS, Yang KC, Ching HJ, Shih CC (1988) An unusual cause of gastrointestinal hemorrhage — intestinal neurofibromatosis. J Clin Gastroenterol 10: 585–587
Marshak RH, Freund S, Maklansky D (1963) Neurofibromatosis of the small bowel. Am J Dig Dis 8: 478–483
Sivak MV, Sullivan BH, Farmer RG (1975) Neurogenic tumors of the small intestine: review of the literature and report of a case with endoscopic removal. Gastroenterology 68: 374–380
Urschel JD, Berendt RC, Anselmo JE (1991) Surgical treatment of colonic ganglioneuromatosis in neurofibromatosis. Can J Surg 34: 271–276
Vujic I, Sbrocchi RD, Stanley JH, Seymour EQ (1983) Angiographic demonstration of gastrointestinal neurofibromas in von Recklinghausen's disease. Gastrointest Radiol 8: 283–284
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mustafa, I.A., Reed, W.P. & Coe, N.P.W. Evaluation of gastrointestinal hemorrhage in patients with neurofibromatosis. Surg Endosc 8, 788–791 (1994). https://doi.org/10.1007/BF00593442
Issue Date:
DOI: https://doi.org/10.1007/BF00593442