A case of active bleeding caused by gastrointestinal stromal tumor of the small intestine diagnosed by videocapsule endoscopy

An 84-year-old woman was admitted to our hospital complaining of tarry stool and anemia. She also had tarry stool three years previously. Gastrointestinal endoscopy and colonoscopy were performed, but the source of the hemorrhage was not detected. Videocapsule endoscopy was performed and located an actively bleeding lesion. The small intestine was examined using double-balloon endoscopy, and a submucosal tumor with ulceration was found. Laparoscopy-assisted partial resection of small intestine was performed. Immunopathological study of the tumor was positive for c-kit, CD34 and α-SMA but negative for S-100 protein, indicating gastrointestinal stromal tumor. Findings with this case suggest that patients with obscure gastrointestinal bleeding should be examined both by videocapsule endoscopy and double-balloon endoscopy.