Abstract
A 58-year-old man was admitted to our emergency department because of melena with hemorrhagic shock occurring during anticoagulant therapy for atrial fibrillation. Contrast-enhanced CT raised the suspicion of bleeding from the jejunum.
Emergency oral small bowel endoscopy showed a 2-cm, type 2 tumor in the upper jejunum, which was diagnosed as a moderately to well-differentiated tubular adenocarcinoma upon examination of the biopsy specimen. The patient underwent partial small bowel resection with adjacent lymph node dissection. He has been followed up for 3 years, and has shown no signs of recurrence. Small bowel cancer is a rare tumor that is difficult to diagnose at a relatively early stage. This case is suggestive in that, despite the small tumor size, the patient developed hemorrhagic shock during anticoagulant therapy, which led to the diagnosis of small bowel cancer on small bowel endoscopy. We report this case with a review of the literature.
