Pseudomelanosis Duodeni :Association with Hyperten-
sion and Chronic Renal Failure : Case Report
SOMBAT TREEPRASERTSUK, M.D.*,
PONGSEPEERA SUWANGOOL, M.D.***,
DUANGPORN THONG-NGAM, M.D.**,
PINIT KULLA V ANIJA Y A, M.D.*
Affiliation : * Division of Gastroenterology, Department of Medicine,
** Department of Physiology,
***Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
AbstractWe present the first reported case with typical endoscopic and histological findings from
Thailand. An 80-year-old man presented with chronic periumbilical abdominal pain for 3
months and melena for one week. He had had hypertension for 17 years, chronic renal failure for
4 years and gouty arthritis for 3 years. Panendoscopy was done and showed diffusely scattered
small black and brown pigmentation over the stomach and duodenum. Tissue biopsies from the
black pigmented lesions were taken for further microscopic and histochemical evaluation.
Histological finding and special histochemical stains, Fontana stain, revealed mild chronic
inflammation with accumulation of hemosiderin pigment in the lamina propria of the stomach and
duodenal villi. This condition is called Pseudomelanosis duodeni. The literature of this condition
was also reviewed.
Keywords : Pseudomelanosis Duodeni, Iron, Hypertension, Chronic Renal Failure
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