In 1963, Rappaport and Shiffman1 reported three male patients who had a history of peptic ulcer, caviar spots of the tongue, angiokeratoma of Fordyce, and multiple phlebectasia of the jejunum. One of the three patients bled from the jejunal phlebectasia. A similar case is described below.
This 53-year-old white man began to have cramping epigastric pain at the age of 21. Gastrointestinal x-ray series was said to disclose "spasms of the duodenum." Medical management gave only partial relief. In 1937, a gastro-intestinal x-ray series failed to disclose a peptic ulcer. In 1947, at age 35, the epigastric cramping became much more frequent lasting months and responding poorly to medical measures. Again, a gastrointestinal series was said to show "spasms of the duodenum." Intravenous pyelography and cholecystography were normal. Intensive ulcer therapy gave relief of symptoms. In 1948, he had one episode of hematemesis and several episodes of
Douglas A. Miller, William A. Akers. Multiple Phlebectasia of the JejunumOral Cavity, and Scrotum. Arch Intern Med. 1968;121(2):180–182. doi:10.1001/archinte.1968.03640020068014