Editor's quiz: GI snapshot
Massive haematemesis in an African male
1 Department of Pathology, Hôpital St-Antoine, AP-HP, Paris, France
2 Department of Surgery, Hôpital St-Antoine, AP-HP, Paris, France
3 Department of Infectious Disease, Hôpital St-Antoine, AP-HP, Paris, France
Correspondence to:
Dr N Mourra, Department of Pathology, Hôpital St-Antoine, 184, rue du Faubourg St-Antoine, 75012, Paris, France; najat.mourra@sat.ap-hop-paris.fr
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 31-year-old man of African origin presented with haematemesis and melena. He previously was healthy, without a history of non-steroidal anti-inflammatory drug (NSAID) use.
On examination, the patient was pale and tachycardic. Laboratory tests showed haemoglobin of 3 g/dl. Upper gastrointestinal endoscopy, performed after blood transfusion, showed a large bleeding ulcer, 2 cm in width with an irregular margin, on the posterior wall of the duodenal bulb. Gastric mucosa was normal, as was the oesophagus. The bleeding seemed to be controlled, after adrenalin injection, but 2 days later the haematemesis recurred.
Laparotomy revealed a perforated ulcer of the duodenal bulb, penetrating the pancreas, and multiple lymph node enlargement around the duodenum and the greater curvature. A gastrojejunostomy was performed. There were no ascites or peritoneal nodules.
Figure 1 shows an H&E stain of the microscopic section of the duodenal ulcer, and 
figs 2 and 3 show a microscopic section of
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Gut 2008 57: 58.[Extract] [Full Text] [PDF]
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