Abstract
Pseudomelanosis duodeni (PD) manifests as speckled black pigmentation or black spots in the duodenal mucosa. PD is a rare, benign condition in which dark pigment accumulates in macrophages located in the lamina propria. There is no known association with pigmentation elsewhere in the gastrointestinal tract or with the use of laxatives. PD is more common in patients with hypertension, chronic renal failure, diabetes mellitus, history of upper gastrointestinal bleeding, and oral iron intake. The pigment is usually located in the lysosomes of mucosal macrophages. Histochemical studies and electron probe microanalysis suggest that several pigments may result in this endoscopic appearance, including lipomelanin, ceroid, iron sulfide, and hemosiderin. A case of PD with angioectasia is presented. Careful endoscopic examination is needed to rule out other duodenal lesions in patients with PD. This article is part of an expert video encyclopedia.
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