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An unusual cause of persistent gastrointestinal
Gustavo Pignaton de Freitas
Public Hospital of Macaé, Rio de Janeiro, Brazil
A 67-year-old woman seeked medical attention for gastrointestinal bleeding, hematemesis and melena for 2 days.
She underwent an upper endoscopy which revealed Mallory-Weiss tears and hemostasis with adrenaline solution
was performed. Lowering of hematocrit persisted and then
she underwent colonoscopy, which revealed diverticular disease in left colon without active bleeding. She underwent a
second upper endoscopy, which disclosed an ulcer at the site
of previous hemostasis. However, there was no active bleeding at that moment. Since hematocrit kept lowering, she
received a blood transfusion during hospitalization, before
performing an additional diagnostic test. An abdominal CT
scan (Figure 1) was performed. Three days after admission,
since patient presented abdominal pain herewith persistent
GI bleeding, based on the findings of CT scan, she underwent laparotomy.
Figura 1. Abdominal CT scan.
What is the diagnosis?
Correspondencia: Gustavo Pignaton de Freitas
E-mail: [email protected]
Resolución del caso en la página 274
Acta Gastroenterol Latinoam 2014;44(3)203