A CASE OF LIPOMA OF THE SMALL INTESTINE CAUSING MASSIVE ANAL BLEEDING DURING CHEMOTHERAPY FOR MALIGNANT LYMPHOMA

Abstract

A 78-year-old man was admitted to the hospital because of massive anal bleeding about 1l in volume during chemotherapy for malignant lymphoma at another hospital. Upper and lower abdominal endoscopy revealed no bleeding site. Hemorrhagic scintigraphy offered a suspicion of bleeding from the jejunum. Under laparotomy, a partial excision of the small intestine was performed, but unfortunately the patient died of multiorgan failure on the 4th postoperative day. Histopathologically, hemorrhage from lipoma of the jejunum was confirmed.
Lipoma of the small intestine is very rare among all gastrointestinal tumors. And it can cause anal bleeding and bloody stools regardless of size of the tumor. It is thought for the case that pancytopenia and bleeding tendency due to chemotheray for the malignant lymphoma had caused massive anal bleeding. In the case of gastrointestinal bleeding during chemotherapy, we must entertain possible bleeding from benign tumor such as lipoma of the small intestine which has been silent until bleeding other than hemorrahge involved in the present disease in the diagnosis and treatment.