Recurrent gastrointestinal bleeding due to smooth muscle tumours of the small intestine.

The cause of recurrent gastrointestinal hemorrhage can be very difficult to identify. When the source of bleeding is beyond the ligament of Treitz the bleeding is often from a smooth muscle tumour of the small intestine. A review of the records of the Royal Victoria Hospital, Montreal, for the past 25 years discovered 14 instances of such tumours, in more than half of which the presenting symptom was recurrent gastrointestinal hemorrhage of obscure origin. Barium contrast roentgenography, endoscopy and radionuclide scanning have not been found helpful in diagnosis. Selective angiography followed by laparotomy is the best mode of management with respect to both investigation and treatment. The data obtained from our series of cases are compared with those of other series reported in the literature.