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At least 55 records · Page 3Linked to original sources
PubMed1985

Symptoms in patients with peptic ulcer and hematemesis and/or melena related to the use of non-steroid anti-inflammatory drugs.

One hundred and seven consecutive patients with hematemesis and/or melena and a diagnosis of duodenal, gastric, or esophageal ulcers were interviewed immediately before or after endoscopy about the use of non-steroid anti-inflammatory drugs (NSAIDs) and symptoms before the hemorrhage. If the patients admitted no symptoms of abdominal pain or discomfort, nausea, vomiting, or heartburn, they were classified as having no ulcer symptoms before the hemorrhage. Patients who had not taken NSAIDs during the last 48 h before the hemorrhage were classified as not having taken NSAIDs. Significantly fewer patients had ulcer symptoms in the group that had used NSAIDs than in the other group (p less than 0.01). This may be interpreted as a possible masking effect by NSAIDs on ulcer symptoms. Physicians and patients should be aware of this possible effect of NSAIDs.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

[Autopsy results of an elderly case of Parkinson's disease and aorto-esophageal fistula who died of a massive hematemesis during prolonged bed rest].

An 81-year-old female patient with an 8-year history of Parkinson's disease was hospitalized because of aspiration pneumonia. The clinical course of her pneumonia was prolonged because of dysphagia with a short period of remission, and she required a long period of bed rest. She received supportive nutrition via a nasogastric tube and many peroral medications that consisted of 3 anti-Parkinsonian drugs and 5 anti-bacterial or anti-tussive agents. Six months after admission, she vomited fresh blood through the nasogastric tube, then went into hypovolemic shock. Hemodynamic stability was temporarily achieved by blood transfusion. Gastroduodenal endoscopic examination could not reveal the exact bleeding site because of massive blood clots. Five days later, the patient died of a massive hematemesis. Autopsy revealed 2 chronic longitudinal ulcers, each 1.7 x 0.4 cm in size, in the upper portion of the esophagus. One of them had developed a fistula to the aorta. Neither esophageal carcinoma nor a foreign body was detected around the fistula. Atherosclerosis of the aorta was mild and the perforation channel was covered with the esophageal epithelium. The fistula was assumed to be a product of local esophageal injury due to drug retention.

Aged↗
PubMed2006

An unusual cause of hematemesis: Goiter.

Downhill varices are located in the upper part of the esophagus and are usually related to superior vena cava obstruction. Bleeding from these varices is extremely rare. We describe a 77-year-old patient with hematemesis due to downhill varices as a result of recurrent goiter. A right lobe thyroidectomy was carried out with disappearance of the varices.

Aged↗
PubMed2004

Forty-two-year-old active duty Marine presents with hematemesis.

A 42-year-old active duty marine presented to the emergency room with hematemesis. This article describes the appropriate step-by-step management for this individual with an upper gastrointestinal bleed, and we discuss potential differential diagnoses and update readers on the current aspects of managing his final diagnosis. Through questions and discussions, we will cover various diagnostic modalities and management strategies related to this case and provide some insight on the military relevance of his final condition.

Acute Disease↗
PubMedDate not supplied

[Spontaneous rupture of the esophagus after hematemesis from gastric ulcer. Report of a case].

The authors discuss a case of spontaneous esophageal rupture consequent to hematemesis associated with gastric ulcer. This is known as Boerhaave's syndrome. The present case was seen in a male patient of 54 years of age. The diagnosis was suspected on the basis of the clinical history and was confirmed by radiologic studies both with and without contrast medium. The patient was treated surgically through a left anterior thoracotomy. In the immediate postoperative period there was an episode of bloody pleural effusion which was corrected by two thoracocenteses. At the present time the patient leads a normal life with no restrictions. He has not had signs or symptoms of gastric ulcer and two esophageal-gastroduodenal series have only shown the esophageal scar.

Esophageal Perforation↗
PubMed2003

[Abdominal aortic aneurysm manifested by hematemesis in a 32 year old patient infected by HIV].

Aortic aneurysm is an uncommon in young patients. The purpose of this report is to describe a case of dissecting aortic aneurysm in a 32-year-old man with human immunodeficiency virus (HIV) infection. The presenting symptom was recurrent massive hematemesis. Diagnosis was suspected on the basis of clinical cardiovascular assessment and confirmed by ultrasonography and computed tomography. The clinical course was complicated by superior vena cava syndrome and kidney failure. Outcome in the absence of surgical treatment was fatal. Perusal of the literature indicates a rising incidence of large vessel disease in young patients with HIV infection. The underlying pathophysiological mechanisms is unclear. Assessment for arterial lesions should be performed in all patients with HIV infection since clinical signs may be misleading. Definitive diagnosis can be achieved by ultrasonography, Doppler ultrasound or computed tomography.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Giant splenic artery mycotic aneurysm presenting with massive hematemesis.

We report a 40-year-old man with rheumatic heart disease who presented with abdominal pain for three weeks and hematemesis for 24 hours. CT scan showed a large splenic artery aneurysm without evidence of pancreatitis. Mycotic aneurysm due to infective endocarditis was considered and confirmed by echocardiogram, which showed aortic and mitral valve regurgitation and vegetations. He was managed successfully with coil embolization of the aneurysm and antibiotics.

Adult↗
PubMed2004

Hematemesis as a presenting symptom of lung cancer with synchronous metastases to the esophagus and stomach. A case report.

A rare case of upper gastrointestinal hemorrhage due to synchronous metastases to the esophagus and stomach from an asymptomatic lung cancer is reported. A 51-year-old white man presented with hematemesis and an emergency endoscopy revealed submucosal tumorous lesions with central ulcerations in the esophagus and stomach. A needle aspiration biopsy revealed the presence of cellular proliferation of adenocarcinoma, which led to the diagnosis of lung cancer, along with a chest radiograph revealing a tumor in the right middle lung field. The importance of conducting an upper gastrointestinal endoscopic examination for staging of patients with lung cancer is stressed.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Testicular choriocarcinoma with gastric metastasis presenting as hematemesis.

We report a 28-year-old man who presented with hematemesis due to choricarcinoma of testis metastatic to the stomach. Gastroscopy showed a polypoidal lesion. Testicular wedge biopsy confirmed mixed germ cell tumor, the choriocarcinomatous portion alone getting metastasized to the stomach. He was initiated on chemotherapy with actinomycin-D, etoposide and methotrexate, but died due to multiple metastases to the lung and brain.

Adult↗
PubMed2006

A 44-year-old woman with hematemesis and cutaneous hemorrhages as a result of superwarfarin poisoning.

The authors present the case of a 44-year-old American Indian woman with hematemesis, spontaneous cutaneous hemorrhages, and multiple ecchymoses. Coagulation factor analyses demonstrated both prolonged prothrombin time (PT, >40 s) and prolonged partial thromboplastin time (PTT, >120 s). Measurement of the serum level of brodifacoum (37 ng/mL), one of the superwarfarin agents commonly used in rodenticides, confirmed poisoning as the cause of the patient's symptoms. Substantial amounts of fresh frozen plasma and vitamin K were required to obtain normal coagulation parameters and maintain these parameters over a 3-week inhospital period. Oral administration of vitamin K (100 mg daily) maintained normal PT (14.1 s), PTT (33.0 s), and international normalized ratio (INR, 1.48) at 2 weeks after the patient was discharged from the hospital. By 2 months postdischarge, PT, PTT, and INR returned to elevated levels because of patient noncompliance with the prescribed tapering vitamin K regimen.

4-Hydroxycoumarins↗
PubMedDate not supplied

Primary small gut volvulus in adult presenting with hematemesis.

Small gut volvulus is rare in adults and usually presents with acute intestinal obstruction. We report a 25-year-old man with primary small gut volvulus who presented with hematemesis. The gangrenous gut was resected at laparotomy. He is well 3 months later.

Abdomen, Acute↗
PubMed1991

Hemoductal pancreatitis secondary to gastroduodenal artery-ruptured pseudoaneurysm: a rare cause of hematemesis.

A 65-yr-old alcoholic man with a history of calcific pancreatitis presented with massive hematemesis complicated by lipothymia. Physical examination disclosed stigmata of chronic liver disease. The laboratory picture was predominantly of cholestatic type with impaired liver protein synthetic activity. Emergency esophagogastroduodenoscopy was unable to provide definitive diagnosis, but reendoscopy with a side-viewing duodenoscope revealed active bleeding through the ampulla of Vater. An ultrasound examination showed a large, complex pancreatic lesion that computed tomography showed to be a pancreatic pseudocyst with an inside pseudoaneurysm. A visceral angiography revealed an anomalous arising of the common hepatic artery from the superior mesenteric artery and a pseudoaneurysm of the gastroduodenal artery at its origin. A second massive hemorrhage required an emergency operation, and surgical liver biopsy revealed focal steatosis. In conclusion, bleeding of a pancreatic pseudoaneurysm may be massive but intermittent, and side-viewing duodenoscopy, even prolonged, is essential in the diagnosis.

Aged↗
PubMed1991

Esophageal tuberculosis: a rare presentation with hematemesis.

Esophageal tuberculosis is rare, with only 26 cases previously reported in the literature. Patients usually present with progressive dysphagia or odynophagia. We report a patient with hematemesis that was later attributed to the erosion of tuberculous subcarinal lymph nodes into the esophagus. This presentation has been described in only two other patients, both of whom died of exsanguinating hemorrhage. The successful outcome in the present case rested on the availability of rapid diagnostic modalities and timely surgical intervention.

Adult↗
PubMed1990

[Esophageal tuberculosis and massive hematemesis].

A patient with esophageal tuberculosis who died of massive hematemesis is described. The origin of the disease was probably pulmonary and the esophageal affliction could have been produced by both the ingestion of contaminated sputum or direct extension from mediastinal lymphatic nodes. The diagnosis was reached by the discovery of caseation granulomas at esophagoscopy and the isolation of Mycobacterium Tuberculosis in the sputum. We comment on the rareness of the disease, clinical and endoscopic features which can resemble a neoplasia. At the same time, we highlight the possibility of serious complications, mainly upper gastrointestinal hemorrhage which is potentially lethal, and the aorto-esophageal communication, thus early diagnosis and surgical treatment being most important.

Aged↗
PubMed1989

[Initial symptoms of hematemesis from gastric varix with chromosomal abnormalities of t(2; 8) and 14q+ in a patient with acute lymphoblastic leukemia (FAB: L3)].

A 71-year-old woman was hospitalized because of hematemesis on December 1, 1987. Her white blood cell (WBC) count was 41,200/microliters with 48% of lymphoblasts, and the bone marrow was hypercellular with more than 90% of blasts. The diagnosis of acute lymphoblastic leukemia (ALL) (FAB: L3) was made by morphologic, cytochemical and immunologic studies of the blasts. The examination of fiber gastroscope revealed remarkable varix in the stomach, suggesting portal hypertension accompanied by infiltration of leukemic cells into reticulo-endothelial system. She died of respiratory failure because of bleeding into the trachea. The autopsy disclosed the massive infiltration of leukemic cells into the whole organs. In the chromosome study of the peripheral blood, t(2; 8) and 14q+ were observed, and these chromosomal abnormalities are relatively unusual in patients with Burkitt's lymphoma.

Aged↗
PubMed1989

Hematemesis due to fistula between aorta and esophagus and later to fistula between left common carotid artery and esophagus. Case report.

A case of massive hematemesis due to an aortoesophageal fistula is presented. The diagnosis was made intraoperatively. The patient died 39 days postoperatively of an additional, previously unidentified fistula between the left common carotid artery and the esophagus. This fistula combination does not seem to have been reported previously.

Aortic Diseases↗
PubMed1987

Massive hematemesis due to an aorto-oesophageal fistula. Case report.

A patient with massive hematemesis due to an aorto-oesophageal fistula is presented. An aorto-oesophageal fistula is mostly a fatal disease. In the literature it is pointed out that recognition of the clinical syndrome with midthoracic pain, massive arterial hemorrhage and exsanguination after a symptom-free interval might ameliorate the prognosis. In the reported patient the correct diagnosis was not immediately suspected. The patient, however, survived a long operation and exsanguination without any major postoperative complications or sequelae.

Aortic Diseases↗