The gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the digestive tract showing differentiation along the line of interstitial cell of Cajal. The most GISTs in the stomach generally show the appearance of submucosal tumors. It is rare for GISTs to appear as a pedunculated polypoid lesion on endoscopy. We experienced a case of a 51-year-old man who had a pedunculated polypoid GIST. He was admitted to our hospital for nausea, vomiting, melena and severe anemia (hemoglobin 3.4 g/dL, hematocrit 10.8%). An upper endoscopy showed gastroduodenal intussusception due to a pedunculated polypoid mass. This report presents a rare case of endoscopically proven gastroduodenal intussusceptions due to pedunculated polypoid GIST in the stomach.
Duodenal Diseases/etiology/*pathology ; Gastrointestinal Hemorrhage ; Gastrointestinal Neoplasms/complications/*pathology ; Gastrointestinal Stromal Tumors/complications/*pathology ; Gastroscopy ; Humans ; Intussusception/etiology/*pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.
Adult ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Intestinal Polyps/diagnosis/*pathology ; Jejunal Diseases/diagnosis/*pathology ; Male

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

No abstract availble.
Adult ; Arteries/abnormalities ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/*etiology/pathology ; Humans ; Intestinal Mucosa/blood supply/pathology ; Jejunal Diseases/*etiology/pathology ; Jejunum/*blood supply/pathology ; Male

BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.
Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Male ; Mallory-Weiss Syndrome/*complications/pathology/therapy ; Middle Aged ; Recurrence

Meckel diverticulum (MD), a congenital gastrointestinal anomaly, is often involved in pediatrics, but less in the adult population. The patient in this report was a 69-year-old female presented with massive gastrointestinal bleeding causing hemorrhagic shock due to MD containing ectopic pancreatic tissue. A review of the literature revealed that gastrointestinal bleeding from MD containing ectopic pancreatic tissue is rare in adults and difficult to be identified preoperation. MD should be considered as one of the differential diagnosis for lower gastrointestinal bleeding, although scarce in adults, especially when the patient has massive painless bleeding.
Aged ; Choristoma ; diagnosis ; physiopathology ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Humans ; Meckel Diverticulum ; diagnosis ; physiopathology ; Pancreas ; pathology

Gastrointestinal Hemorrhage ; etiology ; Humans ; Infant, Newborn ; Intestines ; abnormalities ; pathology ; Male ; Necrosis

OBJECTIVETo investigate the causes of haematochezia in exclusively breast fed infants.

METHODSSeventy-five babies presenting with haematochezia were enrolled. These babies were exclusively breast fed. The age of haematochezia occurrence, concomitant symptoms and laboratory findings (including routine blood test, routine stool test, liver function, stool culture, colonoscopy and histological examination) were recorded. The mothers of the 75 babies were given a diet without animal and floristic proteins for four weeks. The symptoms of haematochzia in the babies were observed after maternal protein-free diets.

RESULTSHaematochezia occurred at an average age of 7.4 weeks. Diarrhea was the most common concomitant symptom (71%). The laboratory testing showed that mild anaemia was the most common (60%). Red cells and white cells were found in the routine stool test. Stool culture was negative. Colonitis was proved through colonoscopy. Twenty babies underwent histological examinations and eosinophilia was noted. Gross hematochezia disappeared 72-96 hrs after maternal protein-free diets.

CONCLUSIONSExclusively breast fed infants may be sensitive to protein taken by their mothers and may appear with haematochazia.

Breast Feeding ; Child, Preschool ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Humans ; Infant ; Male

Bullous pemphigoid is a subepidermal blistering skin disease, usually occurred in the elderly. It is an autoimmune disease associated with circulating autoantibodies directed against structural components of hemodesmosome. Rarely, it can involve the esophagus, which can be complicated by upper gastrointestinal hemorrhage. We report a case of bullous pemphigoid with esophageal mucosal desquamation and hemorrhage in patient with chronic renal failure.
English Abstract ; Esophageal Diseases/*complications/pathology ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Middle Aged ; Mucous Membrane/pathology ; Pemphigoid, Bullous/*complications/pathology

Abdominal Pain ; etiology ; Capsule Endoscopy ; Child ; Gastrointestinal Hemorrhage ; etiology ; Humans ; Intestinal Diseases ; complications ; diagnosis ; etiology ; Intestine, Small ; blood supply ; pathology ; Male ; Telangiectasis ; complications ; diagnosis ; pathology