Intussception due to metastatic melanoma.A middle-aged patient was admitted with small bowel obstruction. No previous abdominal surgery and no hernia found to explain the obstruction. The obstruction did not settle on conservative management. At operation the cause was found to be an intussception - and this was the result of a secondary deposit of melanomas in the intestinal wall. The photograph shows a dilated loop of proximal bowel (on the right), the intussusception and collapsed bowel distal to the obstruction. The gastrointestinal tract is a relatively common site for metastatic melanoma to occur. Sometimes the gut problem may be the first indication of the presence of melanoma. On reviewing this patient's history, he stated that he had a melanoma excised from his back several years previously.
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