EVALUATION OF GASTROINTESTINAL HEMORRHAGE IN PATIENTS WITH NEUROFIBROMATOSIS

Over a 3-year period, two patients with neurofibromatosis were referre d to our medical center for evaluation of repeated episodes of melena. Upper endoscopy was unrevealing in each case, as was colonoscopy. Art eriography during active hemorrhage was helpful in localizing the sour ce of bleeding in one patient but not in the other. The source of blee ding in each patient was obvious at surgical exploration. Large neurof ibromas protruded from the seorsal surface of a short region of jejunu m in both cases and an additional segment of ileum in one case. Hemorr hage had occurred as a result of erosion of mucosa stretched over thes e tumors. Local resection of the involved segments produced long-term control of the hemorrhage. Since these tumors were grossly visible on the serosal surface of the involved intestinal segments, laparoscopic evaluation could have been used to hasten diagnosis in each case.