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• W2912695453 abstract "Introduction: Gastrointestinal melanosis is the term used to describe the accumulation of pigment deposits in the intestinal mucosa. Melanosis coli is a well-known condition associated with the use of anthraceneline laxatives, however melanosis of the small intestine is extremely rare. We report a case of pseudomelanosis inestini involving the pylorus, duodenum, and proximal jejunum in a patient presented with GI bleeding. The clinical significance of this condition is unknown, however gastroenterologists should be aware of its existence. Case Report: A 70 y/o female with a past medical history of atrial fibrillation on warfarin therapy, chronic obstructive pulmonary disease, hypertension, congestive heart failure, and chronic kidney disease stage IIIb, presented with recurrent melena. Her initial EGD revealed a non-bleeding gastric ulcer with a clean ulcer base (Forrest Class III) on the lesser curvature of the gastric antrum, and diffuse duodenal melanosis. She had another episode of melena for which repeated EGD showed same non-bleeding ulcer, and melanosis of the gastric antrum and duodenum. She was treated conservatively and was discharged in stable condition. She presented three weeks later with same complain. Double balloon enteroscopy was performed and revealed melanosis of the duodenum and jejunum (280cm distal to the pylorus). The entire colon and examined portion of the ileum were normal with no evidence of melanosis. Histopathology revealed macrophages containing dark pigmented granules within the lamina propria, which were non-reactive to Perl's iron stain. Discussion: Pseudomelanosis intestine is a benign condition refers to the rare endoscopic appearance of dark pigment deposits in the intestinal mucosa. It can be due to the deposition of melanin-like substances, hemosiderin, lipomelanin, lipofuscin or ferrous sulfate. It usually occurs in patients in their sixth and seventh decade of life with a female predominance. It has been mainly described in patients with certain chronic illnesses, such as chronic kidney disease, hypertension, and GI bleeding. Various medications, such as ferrous sulfate, hydralazine, and furosemide, has been associated with this condition as well. However, the etiologic mechanism, clinical significance, and prognostic and long-term impact of this condition remains unknown. Also, there's no established recommendation regarding the need for therapeutic interventions or regular upper endoscopy survey.Figure: Endoscopic image reveals dark pigment deposits in the pylorus.Figure: Endoscopic image reveals dark pigment deposits in the duodenum." @default.
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• W2912695453 date "2017-10-01" @default.
• W2912695453 modified "2023-09-25" @default.
• W2912695453 title "Pseudomelanosis Intestini" @default.
• W2912695453 doi "https://doi.org/10.14309/00000434-201710001-02410" @default.
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