• Clin Med (Lond) · Apr 2016

    Case Reports

    Lesson of the month 1: Splinter haemorrhages as a pointer to gastrointestinal malignancy.

    • Cositha Santhakumar, Chantal Faddoul, Russell Barker, Rochelle Facer, and Sandhya Limaye.
    • Concord Hospital, Concord, Australia.
    • Clin Med (Lond). 2016 Apr 1; 16 (2): 199200199-200.

    AbstractA 58-year-old man was referred for review due to the finding of splinter haemorrhages and digital infarcts. Further questioning revealed a history of unintentional weight loss and calf pain. There were no other clinical features of endocarditis, and no clear cause for the splinter haemorrhages on initial investigations. The discovery of widespread thromboembolic disease prompted a search for malignancy and an eventual diagnosis of oesophageal adenocarcinoma. Splinter haemorrhages resolved with anticoagulation and directed treatment of the underlying malignancy. This case report reminds clinicians of the potentially broad differential diagnosis associated with this clinical sign.© 2016 Royal College of Physicians.

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