An Unusual Cause of Massive Gastrointestinal Hemorrhage

Abstract

THE SMALL intestine is the most common site of malignant and metastasizing carcinoid tumors and is second only to the appendix as the most frequent site of carcinoid tumor in the gastrointestinal tract. Smallbowel carcinoid tumors without hepatic metastases are usually asymptomatic, and the majority of these are found at autopsy or incidentally at laparotomy.¹With intestinal carcinoids^2,3gastrointestinal bleeding is rarely seen; indeed, massive gastrointestinal hemorrhage as the initial presentation of a carcinoid tumor is most unusual. This report concerns a previously healthy man who had life-threatening lower gastrointestinal bleeding that was subsequently found to stem from a small carcinoid tumor of the terminal ileum. <h3>Report of a Case</h3> A 45-year-old man had been in excellent health until the day when he was admitted to the emergency room of UCLA Hospital with weakness and dizziness after passage of several maroon-colored stools. There was no history of melena,