Unexpected cause of death of patient with upper gastrointestinal bleeding
Authors:
Caha M. 1; Politová P. 1; Vlk R. 2; Kult J. 3; M. Kopáčová 4
Authors‘ workplace:
Interní oddělení 1 – gastroenterologie, Nemocnice Tábor, a. s.
1; Anesteziologicko-resuscitační oddělení, Nemocnice Tábor, a. s.
2; Oddělení patologie, Nemocnice Tábor, a. s.
3; II. interní gastroenterologická klinika LF UK a FN Hradec Králové
4
Published in:
Gastroent Hepatol 2020; 74(1): 50-53
Category:
doi:
https://doi.org/10.14735/amgh202050
Overview
This case report describes a 68-year-old male patient hospitalized for melena and hematemesis. Gastroscopy revealed a bleeding gastric ulcer, for which he was treated. Nevertheless, after achieving successful hemostasis in the stomach, the patient remained hemodynamically unstable. Further investigations revealed active bleeding in his right hemithorax, which led to his death.
Conflict of Interest: The authors declare that the article/ manuscript complies with ethical standards, patient anonymity has been respected, and they state that they have no financial, advisory or other commercial interests in relation to the subject matter.
Publication Ethics: This article/ manuscript has not been published or is currently being submitted for another review. The authors agree to publish their name and e-mail in the published article/ manuscript.
Dedication: The article/ manuscript is not supported by a grant nor has it been created with the support of any company.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio medical papers.
Keywords:
melena – hematemesis – gastric ulcer – hemothorax – ribs fracture
Sources
1. Gralnek IM, Dumonceau JM, Kuipers EJ et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47 (10): a1–a46. doi: 10.1055/s-0034-1393172.
2. Hreinsson JP, Kalaitzakis E, Gudmundsson S et al. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol 2013; 48 (4): 439–447. doi: 10.3109/00365521.2012.763174.
3. Jairath V, Desborough MJ. Modern‐day management of upper gastrointestinal haemor-rhage. Transfus Med 2015; 25 (6): 351–357. doi: 10.1111/tme.12266.
4. Valle JD. Peptic ulcer disease and related disorders. In: Kasper DL, Fauci AS, Hauser SL et al (eds). Harrison’s principles of internal medicine. New York: McGraw Hill Education 2015: 1911–1932.
5. Weil J, Langman MJ, Wainwright P et al. Peptic ulcer bleeding: accessory risk factors and interactions with non-steroidal anti-inflammatory drugs. Gut 2000; 46 (1): 27–31. doi: 10.1136/gut.46.1.27.
6. Søberg T, Hofstad B, Sandvik L et al. Risk factors for peptic ulcer bleeding. Tidsskr Nor Laegeforen 2010; 130 (11): 1135–1139. doi: 10.4045/tidsskr.08.0693.
7. Brignole M, Moya A, de Lange FJ et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J 2018; 39 (21): 1883–1948. doi: 10.1093/eurheartj/ehy037.
8. Ricci F, De Caterina R, Fedorowski A. Orthostatic Hypotension. J Am Coll Cardiol 2015; 66 (7): 848–860. doi: 10.1016/j.jacc.2015.06.1084.
9. Bartoletti A, Fabiani P, Bagnoli L et al. Physical injuries caused by a transient loss of consciousness: main clinical characteristics of patients and diagnostic contribution of carotid sinus massage. Eur Heart J 2008; 29 (5): 618–624. doi: 10.1093/eurheartj/ehm563.
10. Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury 2012; 43 (1): 8–17. doi: 10.1016/j.injury.2011.01.004.
11. Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma 1994; 37 (6): 975–979. doi: 10.1097/00005373-199412000-00018.
12. Novakov I, Timonov P, Stefanov C et al. Rib fractures in blunt chest trauma – morbidity and mortality: self-experience study. Trakia J Sci 2014; 3: 272–276. doi: 10.15547/tjs.2014.03. 008.
13. Sirmali M, Türüt H, Topçu S et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003; 24 (1): 133–138. doi: 10.1016/s1010-7940 (03) 00256-2.
14. Mahoozi HR, Volmerig J, Hecker E. Modern management of traumatic hemothorax. J Trauma Treat 2016; 5 (3): 326. doi: 10.4172/2167-1222.1000 326.
15. Talbot BS, Gange CP Jr, Chaturvedi A et al. Traumatic rib injury: patterns, imaging pitfalls, complications, and treatment. Radiographics 2017; 37 (2): 628–651. doi: 10.1148/ rg.2017160100.
16. Boersma WG, Stigt JA, Smit HJ. Treatment of haemothorax. Respir Med 2010; 104 (11): 1583–1587. doi: 10.1016/j.rmed.2010.08.006.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
2020 Issue 1
Most read in this issue
- Fecal microbiota transplantation – past, present, and future
- Ustekinumab – a new biological therapy of ulcerative colitis
- Unexpected cause of death of patient with upper gastrointestinal bleeding
- Telemedicine and inflammatory bowel disease – results of the IBD Assistant pilot project