Article Text

Download PDFPDF

Case report
Haemorrhagic small bowel melanoma metastasis: a clinical rarity
  1. Alexandros Zoumpos1,
  2. Ngoc Anh Huy Ho1,
  3. Ralf Loeschhorn-Becker2 and
  4. Frank Schuppert1
  1. 1 Department of Gastroenterology, Endocrinology, Diabetology and General Medicine, Klinikum Kassel GmbH, Kassel, Germany
  2. 2 Department of Radiology, Klinikum Kassel GmbH, Kassel, Germany
  1. Correspondence to Mr Alexandros Zoumpos, dent2004gr{at}


We report on a clinical case with haemorrhagic small bowel metastases in a malignant melanoma patient with anaemia, diagnosed using small bowel video capsule endoscopy (VCE). A 67-year-old male patient with a previous diagnosis of malignant melanoma presented with anaemia and vertigo on admission. The standard diagnostic protocol for gastrointestinal (GI) bleeding investigation including a gastroscopy, colonoscopy and small bowel capsule endoscopy, as well as abdominal sonography and a restaging protocol including chest–abdomen–pelvis CT (CAP-CT), echocardiography and ECG was applied. Gastroscopy and colonoscopy were not conclusive in determining the bleeding source. VCE provided evidence for numerous haemorrhagic small bowel metastases. The CAP-CT was unremarkable for small bowel findings. Due to a diffuse metastatic disease diagnosed in heart, brain, liver, spleen and bone metastasis, the patient was treated in a conservative/palliative manner. VCE can provide precious information about GI bleeding of unknown origin when classical diagnostic methods are non-conclusive.

  • gi bleeding
  • endoscopy
  • small intestine
  • small intestine cancer
  • dermatology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors AZ wrote the first draft of the manuscript. FS and NAHH consulted the small bowel video capsule endoscopy study. RL-B consulted the chest–abdomen–pelvis CT study and provided the images. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.