When Every Test Fails: Multifocal Grade 1 Ileal Neuroendocrine Tumors Causing Transfusion-Dependent Obscure Overt Gastrointestinal Bleeding.
- 1Department of Medicine, Henry Ford Hospital, Detroit, MI.
- 2Division of Gastroenterology and Hepatology, Henry Ford Health, Detroit, MI.
Abstract
Small bowel neuroendocrine tumors (NETs) rarely present as obscure overt gastrointestinal bleeding (OGIB), causing significant diagnostic challenges. We report a 56-year-old man who presented with OGIB that required approximately 50 units of packed red blood cells during a 6-week hospitalization. Multimodal evaluation, including computed tomography angiography, tagged red blood cell scan, video capsule endoscopy, computed tomography enterography, provocative mesenteric angiography, balloon enteroscopy, and octreotide scan, failed to identify a source. Exploratory laparotomy identified 3 mid-ileal nodules with histopathology revealing well-differentiated grade 1 neuroendocrine tumors. Bleeding resolved following resection. This case highlights the diagnostic and therapeutic role of surgical exploration in refractory OGIB.
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BibTeX
@article{mo2026when,
title = {{When Every Test Fails: Multifocal Grade 1 Ileal Neuroendocrine Tumors Causing Transfusion-Dependent Obscure Overt Gastrointestinal Bleeding.}},
author = {James Mo and Suraj Suresh},
journal = {ACG case reports journal},
year = {2026},
month = oct,
doi = {10.14309/crj.0000000000002326},
url = {https://europepmc.org/article/MED/42910086},
note = {CC BY},
}
RIS
TY - JOUR
TI - When Every Test Fails: Multifocal Grade 1 Ileal Neuroendocrine Tumors Causing Transfusion-Dependent Obscure Overt Gastrointestinal Bleeding.
AU - James Mo
AU - Suraj Suresh
PY - 2026
DA - 2026/10/21
JO - ACG case reports journal
DO - 10.14309/crj.0000000000002326
UR - https://europepmc.org/article/MED/42910086
AB - Small bowel neuroendocrine tumors (NETs) rarely present as obscure overt gastrointestinal bleeding (OGIB), causing significant diagnostic challenges. We report a 56-year-old man who presented with OGIB that required approximately 50 units of packed red blood cells during a 6-week hospitalization. Multimodal evaluation, including computed tomography angiography, tagged red blood cell scan, video capsule endoscopy, computed tomography enterography, provocative mesenteric angiography, balloon enteroscopy, and octreotide scan, failed to identify a source. Exploratory laparotomy identified 3 mid-ileal nodules with histopathology revealing well-differentiated grade 1 neuroendocrine tumors. Bleeding resolved following resection. This case highlights the diagnostic and therapeutic role of surgical exploration in refractory OGIB.
SN - 2326-3253
ER -