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A push enteroscopy was performed after which showed an ulcerated mass in the third portion of the duodenum. Biopsies confirmed adenocarcinoma. Computed tomography of the abdomen showed no signs of distant metastasis and the patient was referred to surgery for evaluation. The patient underwent a pancreaticoduodenectomy, with resection of the mass and negative lymph nodes in all nine that were removed (T3N0). The patient was classified as stage II duodenal adenocarcinoma. Duodenal adenocarcinoma is a rare but clinically significant cause of small bowel bleeding.<\/jats:p>","DOI":"10.1136\/bcr-2018-227184","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T23:08:57Z","timestamp":1548889737000},"page":"e227184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rare case of small intestine bleeding"],"prefix":"10.1136","volume":"12","author":[{"given":"Jeremy D","family":"Cumberledge","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Digestive Diseases, West Virginia University Hospitals, Morgantown, West Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikenna","family":"Anaka","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Digestive Diseases, West Virginia University Hospitals, Morgantown, West Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin T","family":"Kupec","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Digestive Diseases, West Virginia University Hospitals, Morgantown, West Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,29]]},"reference":[{"key":"2025082622421756000_12.1.e227184.1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.246"},{"key":"2025082622421756000_12.1.e227184.2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1391855"},{"key":"2025082622421756000_12.1.e227184.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2008.10.004"},{"key":"2025082622421756000_12.1.e227184.4","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4240\/wjgs.v8.i3.212","article-title":"Duodenal adenocarcinoma: advances in diagnosis and surgical management","volume":"8","author":"Cloyd","year":"2016","journal-title":"World J Gastrointest Surg"},{"key":"2025082622421756000_12.1.e227184.5","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1038\/bjc.1998.124","article-title":"Molecular pathogenesis of sporadic duodenal cancer","volume":"77","author":"Achille","year":"1998","journal-title":"Br J Cancer"},{"key":"2025082622421756000_12.1.e227184.6","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1626-1-98"},{"key":"2025082622421756000_12.1.e227184.7","unstructured":"Edge SB , Byrd DR , Compton CC , eds. 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