Although the tendency for smooth muscle tumors of the gastrointestinal tract to bleed massively is well known, certain features deserve reemphasis. Benign tumors as small as 2 cm. in diameter are sometimes associated with repeated episodes of exsanguinating hemorrhage over a period of months or years. Rarely, fatal gastrointestinal hemorrhage occurs and the diagnosis is made only at the autopsy table.1,3 A confusing clinical picture results when these repeatedly bleeding leiomyomas are otherwise asymptomatic, cannot be demonstrated by x-ray, and are not palpable through the abdominal wall. Frequently, hemorrhage stops spontaneously after hospitalization, bed rest, and transfusions. In these cases the diagnosis is often mistaken for recurrently bleeding peptic ulcer. Many such patients have been treated with a medical peptic ulcer regimen for long periods prior to correct diagnosis. Between acute episodes of bleeding, patients may be apparently healthy and have no anemia or occult blood loss.
HUNTLEY BF, LAURAIN AR, STEPHENSON WH. Hemorrhage from Leiomyomas of the Gastrointestinal Tract: A Clinical Picture Simulating Bleeding Peptic Ulcer with a Report of Six Cases. Arch Intern Med. 1960;106(2):245–252. doi:10.1001/archinte.1960.03820020085013
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