Journal of the Chinese Medical Association
Volume 71, Issue 2 , Pages 96-99, February 2008

Adenomyoma of the Jejunum—A Rare Cause of Gastrointestinal Bleeding

  • Hsien-Chung Yu

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Gin-Ho Lo

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Kwok-Hung Lai

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Kwok-Hung Lai, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C
    • ,
  • Ping-I Hsu

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • I-Shu Chen

      Affiliations

    • Division of General Surgery, Department of Surgery, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Pin-Pen Hsieh

      Affiliations

    • Department of Pathology, Kaohsiung Veterans General Hospital, Kaohsiung and Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 5 June 2007; accepted 28 September 2007.

Article Outline

Adenomyoma of the small intestine is rare. It occurs mostly in the periampullary region or ileum. The common presentations are intussusception and intestinal or biliary obstruction, depending on the location. To our knowledge, gastrointestinal (GI) bleeding from a jejunal adenomyoma has not been reported previously. We present a 74-year-old female patient who suffered intermittent tarry stool passage for 1 month. Initial upper GI endoscopy, colonoscopy and computed tomography failed to find the bleeder. A papilla-like tumor with central depression and active bleeding in the proximal jejunum was found by push enteroscopy. Exploratory laparotomy showed a submucosal nodule about 1.5 cm in size located about 20 cm distal to the Treitz ligament. Wedge resection was carried out. Pathologic examination revealed that the tumor was composed of some cystic exocrine-type ducts and bundles of smooth muscle, indicating adenomyoma. The patient was symptom-free following operation.

Key Words:  adenomyoma , enteroscopy , gastrointestinal bleeding , jejunum

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PII: S1726-4901(08)70082-0

doi:10.1016/S1726-4901(08)70082-0

Journal of the Chinese Medical Association
Volume 71, Issue 2 , Pages 96-99, February 2008

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