Pseudomelanosis duodeni is a rare finding usually described as a black/brown speckled or tattooed appearance of the intestinal mucosa. Although an incidental finding, it has been associated with different medications and chronic medical conditions such as diabetes mellitus and chronic renal failure. We describe an elderly male who presented with epigastric pain and melena. Endoscopy showed pseudomelanosis duodeni related to intravenous (IV) iron transfusion. To our knowledge, this is the first report of pseudomelanosis duodeni related to IV iron use. In spite of its benign nature, the diagnosis of pseudomelanosis duodeni is essential to rule out other serious medical conditions that mimic its physical findings.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246429PMC
http://dx.doi.org/10.7759/cureus.25500DOI Listing

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Article Synopsis
  • Pseudomelanosis duodeni (PD) is a rare but benign condition characterized by dark speckles in the proximal duodenum, often linked to chronic diseases and certain medications, notably oral iron supplements.
  • A 56-year-old woman with iron-deficiency anemia and a history of peptic ulcers was diagnosed with PD after an endoscopy revealed suspicious findings, confirmed by pathology showing iron-containing macrophages.
  • The case highlights the connection between oral iron therapy and PD development, suggesting further research is needed on long-term outcomes and management strategies for this condition.
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A rare case of pseudomelanosis duodeni.

Asian J Surg

July 2024

Department of Gastroenterology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China. Electronic address:

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Pseudomelanosis of the duodenum and stomach.

Arab J Gastroenterol

August 2024

Emirates Health Services, United Arab Emirates. Electronic address:

Pseudomelanosis duodeni is characterized by endoscopic findings of black or black-brown speckled pigmentation in the duodenal mucosa, usually diagnosed via biopsy. This report presents a case of a 75-year-old male presented with left lower abdominal pain, change in bowel habits, and decreased appetite. Gastroduodenoscopy and biopsies of the duodenum and antrum lead to the diagnosis of pseudomelanosis duodeni.

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