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Editor’s quiz: GI snapshot
Gastric variceal bleeding in a patient with alcohol abuse: business as usual?
  1. Andreas Fischer1,
  2. Burcin Özdirik1,
  3. Dominik Geisel2,
  4. Thomas Malinka3,
  5. Stefan Pahl4
  1. 1 Department of Hepatology and Gastroenterology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  2. 2 Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  3. 3 Department of Surgery, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  4. 4 Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  1. Correspondence to Dr Andreas Fischer, Department of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin Campus Virchow Klinikum, 13353 Berlin, Berlin, Germany; andi.fischer{at}charite.de

https://doi.org/10.1136/gutjnl-2020-321755

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    Clinical presentation

    A 43-year-old man with alcohol use disorder presented to the hospital with acute abdominal pain and recurrent episodes of haematemesis and melena for the last 2 weeks. He reported progressive dyspnoea and fatigue over several days, but denied fever or weight loss. Laboratory findings revealed severe normochromic normocytic anaemia with a haemoglobin concentration of 2.5 g/dL as well as slight leucocytosis and a mildly elevated international normalised ratio of 1.38. Liver and kidney parameters were normal. Urgent upper endoscopy demonstrated a network of gastric varices with a focal ulceration (figure 1) that was treated with cyanoacrylate injection. CT imaging showed …

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    Footnotes

    • Contributors AF cared for the patient, performed endoscopy and wrote the manuscript. BÖ cared for the patient and participated in writing the manuscript. DG performed imaging studies and reviewed the manuscript. TM performed surgery and reviewed the manuscript. SP performed histopatology and reviewed the manuscript. All authors approved the version submitted for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.