Editor's quiz: GI snapshot
A puzzling cause of melaena
1 Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
2 Division of Gastroenterology, Department of Internal Medicine, Kosei Chuo General Hospital, Tokyo, Japan
3 Department of Surgery, Kosei Chuo General Hospital, Tokyo, Japan
4 Department of Diagnostic Pathology, Tokyo Medical University, Tokyo, Japan
Correspondence to:
Dr K Tominaga, Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan; ktominaga@oha.toho-u.ac.jp
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 64-year-old man presented with melaena of 2 weeks in duration and with dizziness for the past day. He had smoked an average of 20 cigarettes per day for 30 years and drunk an average of 360 ml or more of Japanese sake (equivalent to at least 60 g of ethanol) per day for 30 years. Physical examination revealed conjunctival pallor. Laboratory testing revealed anaemia (haemoglobin 7.7 g/dl; normal range: 13.0–16.6 g/dl) and azotaemia (blood urea nitrogen 22.9 mg/dl; normal range: 7.0–21.0 mg/dl and creatinine 0.8 mg/dl; normal range: 0.6–1.1 mg/dl). Oesophagogastroduodenoscopy was performed to investigate his melaena and anaemia, and revealed a mass lesion measuring 55 mm in diameter on the lesser curvature of the upper to middle third of the stomach (fig 1). The gastric lesion was biopsied (fig 2).
Figure 1 Retroflexed endoscopic view of the stomach. A mass lesion is located on the lesser | |||||||||
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ANSWER
Gut 2008 57: 482.[Extract] [Full Text] [PDF]
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