RECURRENT GASTROINTESTINAL BLOOD-LOSS OF OBSCURE ORIGIN - REPORT OF AN EXCEPTIONAL CASE

A 66-year old tailor was admitted because of venous insufficiency of t he left lower leg. During the hospital course, recurrent severe gastro intestinal blood loss developed. A classical approach was extended by enteroscopy and radionuclide scanning, followed by exploratory laparat omy with removal of two intra-abdominal sewing needles and a jejunal l eiomyoma. After surgery, bleeding did not recur. This case illustrates the difficult diagnostic work-up of obscure gastrointestinal bleeding . It also shows that intra-abdominal sewing needles may migrate in the intestinal tract and remain silent during many years, eventually caus ing gastrointestinal bleeding.