A Rare Case of Intestinal Bleeding in a Cancer Patient
Gastrointestinal bleeding (GIB) in patients with malignancies can be a serious urgent problem with a wide etiological range. GIB may also be the first event in the detection of a primary or metastatic gastrointestinal cancer lesion. Identifying the source of the bleeding is important in its treatment. In cancer patients, gastrointestinal bleeding can be caused by common factors (ulcers and erosions of the esophagus, stomach or duodenum, arteriovenous malformation, angiodysplasia, diverticular disease, and inflammatory bowel disease) as well as by complications of ongoing polychemotherapy (PCT). One of the frequent adverse outcomes of PCT can be late severe changes in hematopoiesis (thrombocytopenia, erythrocytopenia), and the development of severe pseudomembranous colitis (PMC) with a hemorrhagic component. Bleedings are most common in the second stage of PMC, requiring surgical intervention, ectomy of the affected parts of the intestine. Rare occurrence of duodenal diverticula as a source of bleeding, difficulty in detecting diverticula during gastroduodenoscopy, and sometimes impossibility to use endovascular methods of diagnosis and treatment make diagnosis difficult. Given this, surgery remains the best method of detecting the source of bleeding and its cessation.