A 64-year-old male patient presented with severe anemia and hematochezia following sunitinib administration for the treatment of pulmonary metastasis of renal cell carcinoma. Sunitinib administration was discontinued because of digestive hemorrhage and pancytopenia. Since a bleeding site could not be detected by esophagogastroduodenoscopy and colonoscopy, small bowel capsule endoscopy (CE) was performed. Angioectasia and blackish intestinal contents around the angioectasia in the middle intestine were found with the CE. We performed transanal double-balloon endoscopy (DBE) , but it could not reach the site of angioectasia. Argon plasma coagulation was then performed during the DBE at distal sites of ileum which were not detected by the CE. After discontinuation of sunitinib and DBE, bleeding stopped and anemia was improved.
