Barbosa OA. Small bowel ulcers and bleeding: An overlooked yet critical clinical challenge. World J Clin Cases 2025; 13(30): 109445 [DOI: 10.12998/wjcc.v13.i30.109445]
Corresponding Author of This Article
Orivaldo Alves Barbosa, MD, Chief Physician, Internal Medicine, Hospital Cesar Cals, Avenida do imperador 545, Fortaleza 60810035, Ceara, Brazil. orivaldo.alves.barbosa@gmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2025; 13(30): 109445 Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.109445
Small bowel ulcers and bleeding: An overlooked yet critical clinical challenge
Orivaldo Alves Barbosa
Orivaldo Alves Barbosa, Internal Medicine, Hospital Cesar Cals, Fortaleza 60810035, Ceara, Brazil
Author contributions: Barbosa OA performed the literature review and wrote the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: May 12, 2025 Revised: May 29, 2025 Accepted: August 13, 2025 Published online: October 26, 2025 Processing time: 153 Days and 12.2 Hours
Abstract
Gastrointestinal (GI) bleeding originating from the small bowel represents a diagnostic and therapeutic challenge, often demanding advanced imaging techniques for accurate identification. Maity et al present a case of a benign ulcerated jejunal GI stromal tumor (GIST) manifesting as overt bleeding, underscoring the importance of considering small bowel neoplasms in obscure GI hemorrhage. Furthermore, recent studies highlight that small intestinal GISTs exhibit more aggressive clinical features compared to gastric GISTs, correlating with worse relapse-free survival and higher rates of GI bleeding. This editorial discusses the implications of these findings and the necessity for comprehensive diagnostic workup in small bowel bleeding.
Core Tip: Small bowel bleeding remains a challenging clinical entity due to its obscure presentation and broad differential diagnosis. This editorial highlights a rare but significant cause—ulcerated jejunal gastrointestinal stromal tumor (GIST)—emphasizing the aggressive behavior of small intestinal GISTs compared to gastric ones. It reinforces the need for a structured diagnostic approach, incorporating capsule endoscopy and enteroscopy, and alerts clinicians to consider both common and rare etiologies, including infectious and genetic causes, when managing small bowel ulcers and bleeding.
