A 50-year-old male with a history of arterial hypertension treated and treated with a cholecystectomy at age 25, presented with epigastric pain, melena and asthenia for 15 days.
He did not report dysphagia, heartburn or altered bowel habits.
The physical examination was normal, there were no signs of malnutrition or masses or visceromegaly in the abdomen.
Laboratory tests revealed hypochromic microcytic anemia with Hgb of 10 gr/dl and Hto of 33%.
Chest and abdominal X-rays showed no changes of interest.
Upper gastrointestinal endoscopy showed a normal esophagus, a gastric cavity without remnants hebacter as a normal mucosa and erosions on an edematous mucosa in the duodenal bulb, gastritis was performed taking biopsies in the antrum.
Abdominal ultrasound showed normal liver, gallbladder and pancreas characteristics.
With the diagnosis of upper gastrointestinal bleeding due to erosive duodenitis and anemia secondary to digestive loss, the patient was discharged for outpatient treatment with antisecretory drugs.
The patient was readmitted three weeks later due to a new episode of melena. A new upper endoscopy showed an esophagus, gastric cavity and bulb, with the rest of the duodenum, appreciable ulceration of the tumor.
A short intestinal transit procedure was performed, showing a proximal stricture that allowed passage of contrast.
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An abdominal CAT scan showed the presence of a mass in proximal extension and alterations without finding regional or retroperitoneal lymph nodes of significant size. No focal lesions were observed.
With the diagnosis of low-grade leiomyosarcoma of the small intestine and after ruling out distant tumor extension or local invasion in imaging studies, surgical treatment was decided with tumor resection and subsequent duodenojejunal anastomosis.
The evolution of the patient was satisfactory without requiring adjuvant treatment.
