[Massive upper gastrointestinal bleeding as first clinical manifestation of pseudoxanthoma elasticum (author's transl)].

We describe a patient with a "cryptogenic" massive upper gastrointestinal bleeding due to a pseudoxanthoma elasticum, recognized only postoperatively. She underwent twice emergency abdominal surgery with total gastrectomy and partial jejunal resection, with a complicated postoperative course. An insufficient enteral anastomosis was perhaps caused by deficient reapir mechanisms of the involved organs due to the underlying disease. Pseudoxanthoma elasticum, an hereditary degenerative disease of especially the elastic connective tissue, involves primarily the vascular system, skin, and eyes, with the typical complication of massive gastrointestinal bleedings. Instead of surgical intervention, such bleedings should be treated preferably by utmost application of conservative means.