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Hemorrhage in the Small Intestine
Etiology

The major causes of small intestinal hemorrhage are: infectious, vascular including infarction and vascular anomalies, bleeding disorders, and tumors
Pathogenesis

Infectious causes of small intestinal bleeding usually cause tissue necrosis either from preformed toxins or replication of organisms with toxin formation within the gut
Small intestinal infarction is due to superior mesenteric obstruction(see SI Infarction)
Bleeding diathesis is most commonly due to thrombocytopenia secondary to hematologic malignancy or chemotherapy
Small intestinal tumors only cause bleeding when they are large enough to cause erosion of the overlying mucosa,
Epidemiology

See individual diseases
General Gross Description

Infectious causes have an erythematous edematous mucosa with necrosis which may be gross or microscopic
Infarction is seen as segmental necrosis of the bowel wall, with an abrupt change from the normal intestine to a dusky hemorrhagic infarcted tissue
Bleeding disorder whether acquired or inherited show punctate hemorrhage in an otherwise normal mucosa
Tumors are usually large intramural GIST tumors with necrosis of the mucosa overlying the tumor
•Examples:
Small Intestinal Hemorrhages Small Intestinal hemorrhage
General Microscopic Description

See individual disorders
•Examples:
Clinical Correlation

Small intestinal hemorrhage is an umcommon site of gastrointestinal bleeding
See individual disorders
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994.

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Hemorrhage in the Small Intestine
Synopsis by: Martin Nadel, M.D. (T64000M37000)[619]
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