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At least 37 records · Page 2Linked to original sources
PubMed2003

Mediastinal bronchial artery aneurysm with hematemesis.

Mediastinal bronchial artery aneurysm is a rare condition which can lead to potentially fatal hemorrhage. In most cases it presents respiratory symptoms due to rupture into pleural parenchyma. But when it develops mediodorsally and compresses the esophagus, it may cause dysphagia or hematemesis. Here we report a case of mediastinal bronchial artery aneurysm which presented with hematemesis. Computed tomography and endoscopic ultrasound showed what seemed to be a submucosal tumor on the esophagus. We were able to correctly diagnose the aneurysm using magnetic resonance imaging and probe thoracoscopy, and were able to successfully treat with transluminal artery embolization.

Aneurysm, Ruptured↗
PubMedDate not supplied

Fibronectin, platelet factor 4 and beta-thromboglobulin in endemic hepatosplenic schistosomiasis: relation to acute hematemesis.

Some platelet alpha-granule contents were assessed in parallel with other markers of hemostatic imbalance in 50 patients with hepatosplenic schistosomiasis (15 patients with compensated hepatosplenomegaly, 15 patients with advanced hepatic fibrosis and ascites and 20 patients during an acute attack of hematemesis from ruptured esophageal varices). Platelet factor 4 (PF4), beta-thromboglobulin (beta-TG), fibronectin (FN), prothrombin fragment 1 + 2, thrombin-antithrombin (TAT) complexes, fibrin degradation products (FbDP) and D-dimer were assessed in schistosomal patients compared to controls (15 healthy subjects). A significant increase in both thrombin (high TAT and prothrombin fragment 1 + 2 levels) and plasmin (high FbDP and D-dimer levels) generation was detected in decompensated patients establishing the presence of a steady state of low-grade disseminated intravascular coagulation, with and without overt bleeding, in these patients. A decrease in plasma FN concentration was found in diseased groups compared to controls. The reduction in plasma levels of FN paralleled the defective liver function and matched the relative decrease in tissue FN in liver specimens of decompensated patients suggesting that FN levels can be used to evaluate the pathological staging of the disease. A significant increase in beta-TG and PF4 levels was noted in decompensated patients with ascites and/or acute hematemesis compared both to controls and compensated patients reflecting platelet alpha-granule release and consequently increased in vivo platelet activation which may initiate and/or perpetuate the pathophysiological mechanisms of the hemostatic imbalance underlying the hemorrhagic diathesis in hepatosplenic schistosomiasis.

Acute Disease↗
PubMed2003

Hematemesis in infants induced by cow milk allergy.

This study was conducted in order to analyze the clinical manifestations, the endoscopic findings, the histology of the gastrointestinal mucosa, the treatments and the clinical course in infants who had hematemesis induced by cow milk allergy. The medical records were reviewed retrospectively. The criteria for the diagnosis of CMA included elimination of cow milk formula resulting in improvement of symptoms, specific endoscopic and histologic findings as well as the exclusion of other causes. Twenty-three infants with a diagnosis of hematemesis were analyzed, which included 20 infants with CMA and 3 infants with gastroesophageal reflux disease (GERD). In the CMA group were 12 girls and 8 boys whose ages were 4.3 +/- 1.4 months. The onset of vomiting after starting cow milk formulas was 70.6 +/- 48.9 days. Gastroduodenoscopy was performed on 15 patients showing erythema, erosion and friability of the gastric mucosa in all patients and lymphoid hyperplasia in the duodenal bulb in 7 patients. Eight patients had mild to moderate eosinophilic infiltration and 5 patients had eosinophilia. Cow milk formulas were changed to other formulas: two children were initially given extensively hydrolyzed casein formulas and later followed by a soy formula, 14 were given a soy formula and 4 were given partially whey hydrolyzed formulas. All patients showed clinical signs of improvement a few days later. Patients that were able to tolerate cow milk were 1.5 +/- 0.9 years old. During the follow-up period (2.6 +/- 1.8 years after treatment) 4 patients were diagnosed with asthma, 4 patients with chronic respiratory symptoms, 4 patients with constipation and 2 others with food allergies. CMA induced gastritis in infancy may not be classified as eosinophilic gastritis because of the low level of eosinophilic infiltration. The elimination of cow milk and subsequent substitution with a soy formula is the proper management.

Animals↗
PubMed1992

Duodenal atresia presenting as hematemesis in a premature infant with Down syndrome. Case report and review of the literature.

Congenital duodenal obstruction, a common complication of Down syndrome, most often presents as neonatal bilious vomiting. We report the first premature infant with Down syndrome whose duodenal atresia presented with a massive hematemesis secondary to duodenitis. Since a plain radiograph of the abdomen is diagnostic in the case of duodenal obstruction, it should be included in the diagnostic workup of hematemesis in newborn infants.

Down Syndrome↗
PubMed1990

The Bouveret syndrome: an unusual cause of hematemesis.

Gallstones are usually silent. Less commonly, patients with cholelithiasis develop symptoms and/or complications; biliary fistula occurs in 3% to 5% of the cases. When a large stone is passed and occludes the duodenum, gastric outlet obstruction (the Bouveret syndrome) may result. In reported cases, the stones are usually larger than 2.5 cm. The usual presenting symptoms are those of bowel obstruction: abdominal pain, nausea, and vomiting. Less commonly, the patients experience melena and, rarely, hematemesis. We describe a patient who had the largest stone reported to cause hematemesis rather than bowel obstruction and to be diagnosed endoscopically. The 5 X 4 X 3 cm stone was extracted surgically. Endoscopic diagnosis and extraction of stones up to 3 cm in size has been reported, avoiding the need for surgery.

Aged↗
PubMedDate not supplied

Stomach strangulated in inguinal hernia presenting with hematemesis.

A case of inguinal hernia containing stomach and presenting with hematemesis is reported. Initial conservative treatment was followed by elective surgery and was successful in this case. The possibility of strangulated stomach as part of the contents of inguinal hernia should be borne in mind in cases of very large hernia, presenting with hematemesis.

Aged↗
PubMedDate not supplied

Hematemesis due to a pseudoaneurysm of the splenic artery secondary to gastric tuberculosis.

Gastric tuberculosis (TB) is very rare compared with other sites in the gastrointestinal (GI) tract, and upper GI bleeding is an extremely rare manifestation of gastric TB. Also, a pseudoaneurysm is an uncommon cause of GI bleeding and is often encountered with pancreatitis. To our knowledge, no case of GI bleeding due to a pseudoaneurysm of the splenic artery secondary to gastric TB has been reported previously. We report a patient who presented with hematemesis due to a pseudoaneurysm of the splenic artery secondary to gastric TB.

Adult↗
PubMed1992

Prolapsed hyperplastic gastric polyp causing gastric outlet obstruction, hypergastrinemia, and hematemesis in an infant.

An infant presented with hematemesis and gastric outlet obstruction. Preoperative diagnosis of duodenal duplication cyst was based on a collaboration of radiological studies. At exploration the patient was found to have a gastric polyp that had intussuscepted into the duodenum leading to obstruction and hypergastrinemia secondary to gastric mucosa in the duodenal alkaline environment.

Gastric Outlet Obstruction↗
PubMed2005

[Hematemesis in an 11-month-old child: an unusual symptom revealing a foreign body in the stomach].

Ingestion of foreign body has often no consequence. We report on a case in an 11-month-old girl who was referred for mild hematemesis and anorexia. Upper digestive tract endoscopy found a small metallic foreign body in the gastric antrum. After its removal, all symptoms disappeared. It is usually recommended to remove foreign bodies by endoscopy when they are in esophageal position, or are more than 3 to 5 cm long, or have a shape that may hurt the gut mucosa. Although rare, a gastric foreign body should be searched for in face of an upper gastrointestinal bleeding in an infant.

Female↗
PubMed2000

Aortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft.

A 59-year-old man with an esophageal carcinoma developed massive hematemesis due to aortoesophageal fistula after irradiation therapy reached 58 Gy. Emergent treatment with an endovascular stent-graft was successfully performed and the patient followed an uneventful course until he died of pneumonia 4.5 months later, which was caused by a tracheoesophageal fistula. Stent-graft repair is a safe and effective method to treat aortoesophageal fistula and may be an alternative to surgical resection.

Aortic Diseases↗
PubMed2002

[The patient with hematemesis. What to do?].

In patients with hematemesis an emergency endoscopy has to be done as soon as possible. In ulcer disease emergency endoscopic treatment is indicated in ulcers with active bleeding or with visible vessels in the base of the ulcer. There is no significant difference in the efficacy between the various endoscopic methods of hemostasis. Gold standard in the treatment of acute variceal bleeding is the hemostasis by endoscopic ligation or sclerotherapy. Because of the very low complication rate variceal ligation is the therapy of choice in the prevention of variceal rebleeding. Especially in patients with preexisting portal hypertensive gastropathy an additional therapy with beta-blocker is recommended. In the prevention of first variceal bleeding a combination therapy with beta-blocker and nitrate is indicated in patients with big varices with red colour signs and in patients with decompensated liver cirrhosis (Child B).

Adrenergic beta-Antagonists↗
PubMed2006

Extramedullary relapse of multiple myeloma presenting as hematemesis and melena.

BACKGROUND: A 60-year-old woman with multiple myeloma relapsed after a good partial response to high-dose chemotherapy (melphalan 200 mg/m(2)) and autologous stem-cell transplantation, followed by thalidomide and prednisolone maintenance therapy. She presented with hematemesis and melena following salvage chemotherapy with dexamethasone, cyclophosphamide, etoposide, cisplatin, and rescue therapy with single-agent bortezomib. INVESTIGATIONS: Physical examination, laboratory investigations, gastroscopy, 2-[(18)F]fluoro-2-deoxyglucose-PET (FDG-PET), breast biopsy and histology. DIAGNOSIS: Multifocal extramedullary relapse of multiple myeloma involving the stomach and duodenum. MANAGEMENT: High-dose infusion of omeprazole, blood product support, palliative analgesics and anxiolytic agents.

Diagnosis, Differential↗
PubMed1986

Hematemesis caused by jejunogastric intussusception.

A case of hematemesis caused by jejunal gastric intussusception diagnosed by gastroscopy is presented. The acute form of gastric intussusception is a rare condition after gastric surgery, but it is important to be aware of the remote possibility because of a tremendously high mortality, if treatment is delayed more than 48 hours. The gastroscopic evaluation of the acute type may be extremely difficult, especially after gastric resection, the survey being very poor.

Aged↗
PubMed1996

Hemoptysis and hematemesis due to a broncholith: granulomatous mediastinitis.

A 40-year-old man had new onset of hemoptysis and hematemesis. Bronchoscopy revealed red, inflamed mucosa with apparent rich blood supply in the left primary bronchus. Computed tomography revealed calcified subcarinal lymph nodes with a small extension into the left primary bronchus. Shortly after admission, the patient had an episode of gastrointestinal bleeding. Esophagogastroduodenoscopy showed a lesion in the posterior wall of the esophagus, 12 cm from the upper incisors. During exploratory thoracotomy, a single piece of irregular-shaped tan tissue measuring 3.5 x 2.5 x 2.0 cm and engulfing the esophagus, carina, and left primary bronchus was dissected. A single stonelike mass, or broncholith, was found to involve both the trachea and the esophagus. Microscopic examination showed multiple caseating granulomas with surrounding lymphoid tissue and germinal centers. During 12 months of follow-up, the patient has remained asymptomatic. The chronic inflammation in this case suggested granulomatous mediastinitis, a rare disease whose mass-like effects may contribute to structural compression. The trachea and esophagus are rarely involved. Tuberculosis and histoplasmosis are thought to be the two most common causes of granulomatous mediastinitis. Chronic inflammation leading to calcification and broncholith may invade bronchial lumen or esophageal wall, causing life-threatening hemorrhage and necessitating prompt surgical intervention.

Adult↗
PubMed2001

Brief clinical report: duodenal laceration presenting as massive hematemesis and multiple intraabdominal abscesses after laparoscopic cholecystectomy.

SUMMARY: Laparoscopic cholecystectomy is considered the gold standard for gallstone disease. Nevertheless, possible severe complications must not be underestimated. Bowel injuries are uncommon, but they are one of the most lethal technical complications of laparoscopic surgery. These injuries were commonly unrecognized at the time of procedures and were diagnosed later when the patients experienced sepsis, peritonitis, intraabdominal abscess, or enterocutaneous fistula. Although duodenal lacerations have been reported with laparoscopic cholecystectomies, they seem to be rare; approximately 30 such cases have been documented previously in the English literature. We report the case of a patient with thermal duodenal injury caused by elective laparoscopic cholecystectomy at an outside center presenting as massive hematemesis and multiple intraabdominal abscesses on the ninth postoperative day. The diagnosis and management of this rare complication of laparoscopic cholecystectomy are described, and the literature is reviewed.

Abdominal Abscess↗
PubMed2005

Jejunogastric intussusception: an unusual cause of hematemesis.

Jejunogastric intussusception is an uncommon but potentially life-threatening complication of a previous gastrojejunal anastomosis. Although jejunogastric intussusception was first described in 1914, fewer than 200 cases have been reported in the English literature thus far. Awareness of this rare complication would help in early diagnosis and appropriate management. Described here is a case report of a patient who presented with hematemesis due to an acute jejunogastric intussusception associated with gangrene of the intussuscepted jejunum.

Abdomen, Acute↗
PubMed2003

Upper gastrointestinal bacillary angiomatosis causing hematemesis: a case report.

A 38-year-old HIV-positive woman presented with massive hematemesis on initial admission to hospital. Endoscopy revealed ulcerated nodular lesions in the esophagus, stomach, and duodenum. The clinical impression was of Kaposi's sarcoma. The stomach was biopsied when the patient re-presented, and another endoscopy was performed. The biopsy showed mucosal ulceration with a proliferation of vascular channels associated with neutrophils and clumps of purplish, granular bacterial colonies, which were highlighted by a Warthin-Starry stain. The histopathological features were typical of bacillary angiomatosis. This case highlights bacillary angiomatosis involving the gastrointestinal tract at multiple sites, the cause of massive upper gastrointestinal hemorrhage that was the initial presentation of an HIV-positive patient, and the occurrence of visceral bacillary angiomatosis in the absence of cutaneous lesions.

AIDS-Related Opportunistic Infections↗
PubMed2001

Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature.

BACKGROUND: Jejunogastric intussusception (JGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. CASE PRESENTATION: A young man presented with epigastric pain and bilous vomiting followed by hematemesis,10 years after vagotomy and gastrojejunostomy for a bleeding duodenal ulcer. Emergency endoscopy showed JGI and the CT scan of the abdomen was compatible with this diagnosis. At laparotomy a retrograde type II, JGI was confirmed and managed by reduction of JGI without intestinal resection. Postoperative recovery was uneventful. CONCLUSIONS: JGI is a rare condition and less than 200 cases have been published since its first description in 1914. The clinical picture is almost diagnostic. Endoscopy performed by someone familiar with this rare entity is certainly diagnostic and CT-Scan of the abdomen could also help. There is no medical treatment for acute JGI and the correct treatment is surgical intervention as soon as possible.

Adult↗