JEJUNAL CIRSOID ANEURYSM - A RARE CAUSE OF MASSIVE LOWER GASTROINTESTINAL HEMORRHAGE

Diverticulosis and angiodysplasia are the most common causes of massiv e lower gastrointestinal hemorrhage. Lower gastrointestinal hemorrhage frequently resolves without, determination of a definitive source. An uncommon cause of lower gastrointestinal tract hemorrhage is the smal l intestinal submucosal aneurysm. This poorly described entity, more c ommonly recognized as Dieulafoy's disease in the gastric mucosa, has b een documented only rarely in the jejunum. We describe a case report o f a 27-year-old man with a massive lower gastrointestinal hemorrhage. Diagnostic evaluation failed to identify the source on initial admissi on. The patient re-presented to the emergency room with recurrent blee ding, anemia, and hypotension. During a period of active bleeding, a n umber of diagnostic studies ultimately revealed the source to be the p roximal jejunum. Inspection of the resected specimen identified a subm ucosal aneurysm on the mesenteric border. Histologic evaluation identi fied the pathologic entity as a cirsoid aneurysm.