Massive bleeding from acute multiple nonspecific ulcer of the small intestine after R-CHOP with a diffuse large B-cell lymphoma: A rare case report
Kazuya Kato, Atsushi Nagase, Kazuhiko Onodera, Minoru Matsuda, Yurina Kato, Kimitaka Kato, Takako Kawakami, Mineko Higuchi, Yoshiaki Iwasaki, Masahiko Taniguchi, Hiroyuki Furukawa
Am J Case Rep 2011; 12:198-202
Background: The small intestine between the second part of the duodenum and ileocecal valves is an uncommon site for hemorrhage. Ulcers of the small intestine are rare and in most cases are caused by infections, inflammatory bowel diseases, malignancies or drugs. Ulcers of the small intestine are sometimes associated with massive, life-threatening hemorrhage and are difficult to diagnose.
Case Report: We report a case of acute, massive bleeding from multiple small-bowel ulcers in a 78-year-old woman with malignant lymphoma (diffuse large B-cell lymphoma) after R-CHOP (cyclophosphamide, vincristine, doxorubicine, prednisolone and rituximab) therapy.
Conclusions: The current report describes a rare case of acute, multiple, nonspecific small intestine ulcers associated with massive gastrointestinal bleeding and presents a review of the literature.
Keywords: Small intestine (jejunum, ileum), nonspecific ulcer, Small intestinal ulceration, malignant lymphoma (diffuse large B-cell lymphoma, DLBCL), gastrointestinal bleeding, CMUSE (cryptogenic multifocal ulcerous stenosing enteritis), Thyroid Gland, R-CHOP therapy