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December 8, 1951


Author Affiliations

Omaha; Lincoln, Neb.

From the General Surgical and Medical Services of the Veterans Administration Hospital, Lincoln, Nebraska. (Dr. Kleitsch is now at the Veterans Hospital, Omaha.)

JAMA. 1951;147(15):1434-1436. doi:10.1001/jama.1951.03670320034012

Gastrointestinal hemorrhage, both acute and chronic, may result from involvement of the bowel in a generalized process of neurofibromatosis, also known as von Recklinghausen's disease. In a classical case of this disease a diagnosis is not difficult to make. In such cases, intestinal hemorrhage of obscure origin should be easy to evaluate. Often, however, neurofibromatosis occurs as a subclinical disease and the diagnosis may be readily overlooked. The patient may have no more than a few pigmented areas and/or a few subcutaneous nodules. However, it must be remembered that neurofibromatosis is always a generalized disease and bowel involvement is not uncommon. Therefore, when gastrointestinal bleeding of obscure origin is encountered, an effort should be made to rule out the possibility of neurofibromatosis; and conversely, when intestinal hemorrhage or chronic anemia occurs in a case of neurofibromatosis, gastrointestinal involvement should be suspected.

We are reporting two cases of severe gastrointestinal hemorrhage

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