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| Hemorrhage in the Small Intestine |
| Etiology •The major causes of small intestinal hemorrhage are: infectious, vascular including infarction and vascular anomalies, bleeding disorders, and tumors |
| Pathogenesis •Infectious causes of small intestinal bleeding usually cause tissue necrosis either from preformed toxins or replication of organisms with toxin formation within the gut •Small intestinal infarction is due to superior mesenteric obstruction(see SI Infarction) •Bleeding diathesis is most commonly due to thrombocytopenia secondary to hematologic malignancy or chemotherapy •Small intestinal tumors only cause bleeding when they are large enough to cause erosion of the overlying mucosa, |
| Epidemiology •See individual diseases |
| General Gross Description •Infectious causes have an erythematous edematous mucosa with necrosis which may be gross or microscopic •Infarction is seen as segmental necrosis of the bowel wall, with an abrupt change from the normal intestine to a dusky hemorrhagic infarcted tissue •Bleeding disorder whether acquired or inherited show punctate hemorrhage in an otherwise normal mucosa •Tumors are usually large intramural GIST tumors with necrosis of the mucosa overlying the tumor |
| General Microscopic Description •See individual disorders |
| Clinical Correlation •Small intestinal hemorrhage is an umcommon site of gastrointestinal bleeding •See individual disorders |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994. |
| Hemorrhage in the Small Intestine |
| Synopsis by: Martin Nadel, M.D. (T64000M37000)[619] |
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