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Duodenal adenocarcinoma: uncommon cause of chronic blood loss in the elderly.

Case 1 An 87-year-old man presented with malaise, anorexia and loss of weight for three months. Initial investigations showed a haemoglobin of 5.1 g/dl, mean corpuscular volume (MCV) 62 fl and serum ferritin 10 sLg/l. Upper gastrointestinal endoscopy revealed an apparently benign duodenal ulcer. Biopsies were taken and revealed a poorly differentiated duodenal adenocarcinoma. The patient refused any further investigations or invasive treatment. He was transfused and discharged home 14 weeks after his initial symptoms. He died ofpost-operative pneumonia following a repair of a non-pathological hip fracture 14 weeks after being discharged.