Retrograde jejuno-gastric intussusception is an unusual complication after gastroenterostomy. It is very difficult to diagnosis this illness before endoscopy or operation, so a high clinical suspicion is needed to make the diagnosis .There have been only 300 reported cases of this illness. There are four types of jejuno-gastric intussusception that are defined anatomically. Intussusception of the efferent limb of the jejunum is the most frequent type. Although the causative factors are not well known, this disease has a poor outcome unless it's treats promptly within 48 hours. We report here a case of hematemesis caused by intussusceptum from the efferent limb to the afferent limb of Braun anastomosis.
Diagnosis ; Endoscopy ; Extremities ; Gastroenterostomy ; Hematemesis ; Intussusception* ; Jejunum

Intramural dissection of the esophagus is a rare esophageal disorder which reveals characteristic endoscopic and radiologic features. Some authors have recognized that this injury is an intermediate stage between a transmural esophageal rupture (Boerhaave's syndrome) and an esophageal mucosal tear (Mallory-Weiss syndrome). Presenting symptoms are sudden severe retrosternal pain, hematemesis, odynophagia, and dysphagia. The diagnosis is made by contrast esophagography, esophageal endoscopy, or both. Conservative management is usually successful. Surgery should be reserved for the cases of protracted disease or perforation with mediastinitis. We report a case of spontaneous intramural esophageal dissection, in which the symptom of dysphagia did not improve with a conservative management. Then we treated with an endoscopic incision of the septum between the true and false lumens using a needle type papillotome.
Deglutition Disorders ; Diagnosis ; Endoscopy ; Esophagus* ; Hematemesis ; Mediastinitis ; Needles ; Rupture

Aortoesophageal fistula (AEF) is a rare and potentially fatal disease that causes massive gastrointestinal bleeding. Therefore, early diagnosis and treatment are essential to prevent mortality. Controlling the massive bleeding is the most important aspect of treating AEF. The traditional surgical treatment was emergent thoracotomy, but intraoperative or perioperative mortality was high. We report a case of a patient presenting with hematemesis who was successfully treated by a staged treatment, in which bridging thoracic endovascular aortic repair was followed by delayed surgical repair of the esophagus and aorta.
Aorta ; Early Diagnosis ; Esophagus ; Fistula ; Hematemesis ; Hemorrhage ; Humans ; Mortality ; Thoracotomy

Hematemesis is a rare condition in infants and can be a symptom of cow's milk-induced hemorrhagic gastritis. Other clinical manifestations of cow's milk allergy are vomiting, malnutrition and anemia. The criteria for the diagnosis of cow's milk allergy includes elimination of cow milk formula resulting in improvement of symptoms, specific endoscopic and histologic findings as well as exclusion of other causes. Cow's milk allergy should be considered in the etiologic differential diagnosis of hematemesis and gastritis in infancy. We have experienced a 1-month-old female infant with hematemesis due to cow's milk-induced hemorrhagic gastritis, and report the case with a review of previously published cases.
Anemia ; Diagnosis ; Diagnosis, Differential ; Female ; Gastritis* ; Hematemesis ; Humans ; Infant ; Infant, Newborn ; Malnutrition ; Milk Hypersensitivity* ; Milk* ; Vomiting

Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome. Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed. Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically. Pediatric gastroenterologists should include duodenal stenosis in the differential diagnosis of older infants and children with vomiting and should be familiar with the endoscopic appearance of this lesion.
Child ; Constriction, Pathologic* ; Diagnosis* ; Diagnosis, Differential ; Down Syndrome ; Duodenal Obstruction ; Hematemesis ; Humans ; Infant* ; Male ; Vomiting

Primary aortoenteric fistula is a direct communication between the aorta and intestinal lumen and it represents a rare but potentially lethal complication of an abdominal aortic aneurysm. However, it may occur less frequently in a naive non-aneurysmatic aorta. Diagnosis is often difficult and delayed in most cases, unless there is a high level of clinical awareness. Urgent surgery is still the recommended treatment. We describe the case of primary aortoenteric fistula of a saccular aneurysm. A 55-year-old woman was referred to our center with hematemesis, melena, and severe anemia who was dignosed previously with unknown saccular abdominal aneurysm.
Anemia ; Aneurysm* ; Aorta ; Aortic Aneurysm, Abdominal ; Diagnosis ; Female ; Fistula* ; Hematemesis ; Humans ; Melena ; Middle Aged

BACKGROUND AND AIMS: The Dieulafoy's lesion is an unusual cause of massive gastrointestinal bleeding resulting from the erosion of an abnormally large submucosal artery. Surgical intervention was believed to be the best treatment in the past, but recently improvement of endoscopic techniques has made effective hemostasis possible in most cases of Dieulafoy's lesions. Therapeutic endoscopic hemostasis includes sclerotherapy, electrocauterization, laser coagulotherapy, clipping band ligation. The effectiveness of the endoscopic band ligation was evaluated in bleeding Dieulafoy's lesions. METHODS: Clinical characteristics, initial endoscopic findings, and effectiveness of band ligation in Dieulafoy's lesions were all analyzed. RESULTS: 1) The patients were 8 males and 1 female, and the mean age was 56.2 years. 2) The chief complaints were melena and hematemesis, and 2 cases had histories of recurrent gastrointestinal bleeding. 3) The diagnosis of Dieulafoy's lesion was possible in 7 of 9 patients (78%) at the initial endoscopy. 4) The lesions were mostly located in the fundus and the body, characterized mainly by protruding vessels in shallow erosion areas. 5) The initial band ligation was possible with successful hemostasis, but additional sclerotherapy was necessary in two cases. There were no complications related to the procedure, except a case of early band detachment. CONCLUSIONS: The Dieulafoy's lesion requires careful endoscopic observation for diagnosis, and endoscopic band ligation was an effective therapeutic option for bleeding Dieulafoy's lesions.
Arteries ; Diagnosis ; Endoscopy ; Female ; Hematemesis ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Ligation* ; Male ; Melena ; Sclerotherapy

The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.
Biopsy ; Carcinoid Tumor* ; Diagnosis ; Hematemesis ; Hemorrhage ; Melena ; Rare Diseases ; Stomach Neoplasms* ; Syncope

Recent advances in both the diagnosis and treatment of hepatocellular carcinoma have improved the prognosis and changed the clinical significance of the recently increasing distant metastases. Distant metastases found after successful treament of the primary lesions are of great clinical significance for the treatment of hepatocellular carcinoma. The duodenum is a rare site of hematogenous metastases or direct invasion from hepatocellular carcinoma. A 23 year old man was admitted with upper gastrointestinal bleeding. He had been diagnosed with hepatocellular carcinoma and treated by a left lobectomy and chemoembolization. The patient was admittted for 12 months after the treatment of the primary tumor. Endoscopic examination revealed a mass in the duodenal bulb that protruded into the lumen. He died due to massive hematemesis. We report on a rare case of hepatocellular carcinoma with duodenal invasion in a 23-year-old male patient.
Carcinoma, Hepatocellular* ; Diagnosis ; Duodenum ; Hematemesis ; Hemorrhage* ; Humans ; Male ; Neoplasm Metastasis ; Prognosis ; Young Adult

A 35-year old male developed epigastric pain and hematemesis one week before admission. Esophagogastroduodenoscopy was performed and a communication between the esophagus and another opening was discovered. On a follow-up CT and barium esophagogram, a tubular duplication was suspected and the patient was referred to the department of cardio-thoracic surgery. A pathological diagnosis of esophageal duplication (tubular type) was established. The patient was discharged and is currently being followed up. Esophageal duplication is a rare congenital malformation. Moreover, it has not heen reported in Korea that esophageal duplication presents with hematemesis.
Adult ; Barium ; Diagnosis ; Endoscopy, Digestive System ; Esophagus ; Follow-Up Studies ; Hematemesis* ; Humans ; Korea ; Male