Small intestinal ulceration secondary to carcinoid tumour arising in a Meckel's diverticulum

A solitary small intestinal ulcer associated with a carcinoid tumour in a n earby Meckel's diverticulum was found in a 77 year old man presenting with massive rectal bleeding. Angiography and a radioisotope study localised the bleeding to the ileum. At operation, the Meckel's diverticulum was identif ied, with bleeding from an ulcer just distal to it. Pathological examinatio n revealed a small carcinoid tumour confined to the Meckel's diverticulum. Close to the opening of the diverticulum, within the ileum, a well demarcat ed ulcer was present. Histology showed a non-specific ulcer which eroded a large blood vessel. This is the first documented occurrence of solitary sma ll intestinal ulceration in association with a carcinoid tumour. Carcinoid tumour should be added to the list of possible causes of small intestinal u lceration. The ulceration may be secondary to release of cytokines by the t umour.