Amyloidosis of the gastrointestinal tract is rare and can be overlooked clinically in favour of infectious gastroenteritis or inflammatory bowel disease. This case report summarizes the clinical, endoscopic and pathologic findings in a patient with no significant past medical history who presented with signs and symptoms suggestive of inflammatory bowel disease. Upon histologic evaluation, however, he was found to have gastrointestinal amyloidosis. He was subsequently admitted to a local hospital with hypotension and hypoalbuminemia where he unfortunately died three days after admission. No autopsy or further subtyping of amyloid was performed. Such acute presentations of gastrointestinal amyloidosis are highly unusual and should be in the differential diagnosis when evaluating older males with inflammatory bowel disease-like symptoms. We also summarize the literature on histologic features of amyloid type (AA, AL, and ATTR). These can be of use to the pathologist when ancillary tests are not available and can guide subsequent testing and intervention.
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