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Abstract

Pseudomelanosis of the upper gastrointestinal tract is rare and classically associated with oral iron intake, upper gastrointestinal bleeding, diabetes mellitus, end stage renal disease and antihypertensive medication use. Duodenal involvement is well described, but only few cases of combined stomach and duodenal involvement have been reported to date. The lesion is indolent but can mimic more concerning entities like malignant melanoma. We report an 84-year-old man who presented with lower gastrointestinal bleeding and was found to have areas of blackened gastric and duodenal mucosa on endoscopy, which was confirmed as gastric and duodenal pseudomelanosis on microscopy.