Subcentimeter Ileal Neuroendocrine Tumor Resection for Obscure Gastrointestinal Bleeding Followed by Pacemaker-Treated Sick Sinus Syndrome: A Case Report.
Jordan Llerena-Velastegui, Gil Bermeo-Sevilla, Francisco Nunez-Medina et al.
✦ AI-curated · Sources linked
Case in brief
A 72-year-old man presented with melena and abdominal discomfort, with prior endoscopies yielding no diagnosis. Multiphase computed tomographic enterography identified an 11Ă—8 mm enhancing nodule in the distal small bowel. Surgical intervention involved segmental ileal resection and appendectomy, revealing a grade 1 small-intestinal neuroendocrine tumor with lymph node metastasis. Postoperatively, the patient developed bradycardia due to sinus node dysfunction, necessitating pacemaker implantation.
Diagnostic / clinical pearl
In cases of obscure gastrointestinal bleeding with negative endoscopy, multiphase CTE can effectively localize small hypervascular lesions, guiding surgical management.
Why it matters
This case highlights the importance of monitoring for cardiac complications in older patients post-surgery, as significant bradyarrhythmias may arise unexpectedly.