Editor's quiz: GI snapshot

A rare cause of obscure gastrointestinal bleeding

W-L Wang¹, J-Y Lee¹, J-T Lin¹, K-L Liu², H-P Wang³

¹ Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
² Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
³ Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Correspondence to:
Dr Hsiu-Po Wang, Department of Emergency Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan; wanghp@ntu.edu.tw

The first 150 words of the full text of this article appear below.

CLINICAL PRESENTATION

A 45-year-old man was referred to our hospital because of repeated gastrointestinal bleeding from an unknown origin. The bleeding had been recurrent over a period of 4 months and was usually preceded by postprandial epigastric pain. Upper gastrointestinal endoscopy and colonoscopy had been performed twice previously in another hospital without identifying the source of bleeding. The patient had a history of hypertension, but was not receiving any regular treatment. No history of gastrointestinal lesions was reported and the patient also denied alcohol abuse or receiving steroid or anti-inflammatory drugs.

On admission, the patient’s blood pressure was 167/119 mm Hg and pulse rate was 95/min. Physical examination was unremarkable except for a pale conjunctiva. The patient’s haemoglobin and mean corpuscular volume levels were 9.3 g/dl and 73.5 fl, respectively. In our hospital, repeated upper gastrointestinal endoscopy (fig 1), ultrasonography (fig 2), and computed tomographic (CT) scan (. . . [Full text of this article]

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ANSWER
Gut 2008 57: 886. [Extract] [Full Text] [PDF]