A CASE OF MELANOSIS JEJUNI, DEVELOPED LONG TIME AFTER TOTAL GASTRORECTOMY WITH ESOPHAGOJEJUNAL ANASTOMOSIS

Abstract

We report a case of 82 year-old male who developed melanosis of the jejunum. Heunderwent total gastrectomy with espyhagojejunostomy ans Roux-en-Y anastomosis 15 years before for early gastric cancer of rheumatoid arhritis and anemia. He was admitted to the hospital because of anorexia.Upper gastrointestinal endoscopy revealed dark-brown peppery speckles in the proximal jejunal mucosa. Light microscopy showed brown pigments in the lamina propria mucosa of jejunum. Electron microscopy showed that the pigments were localized in the lysosomes of the macrophage.Electron probe X-ray analysis disclosed that the pigments contained iron and sulfur. This is the second reported case of melanosis jejuni in the world literature.