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

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

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

Retrograde jejunal intussusception is a rare complication following gastric surgery. Unless this complication is suspected, diagnosis is very difficult. Early diagnosis is very important in preventing avoidable morbidity and mortality. Awareness of this rare complication would help in early diagnosis and appropriate management. We present a case of an 84-year-old woman who visited the emergency department with hematemesis. Endoscopy and a computed tomography scan revealed a retrograde jejunojejunal intussusception, which was treated by surgical manual reduction.
Aged, 80 and over ; Early Diagnosis ; Emergencies ; Endoscopy ; Female ; Hematemesis ; Humans ; Intussusception

We report an unusual case of metastatic thyroid papillary carcinoma directly invades the esophagus presenting as an intraluminal polypoid mass which causes hematemesis. The patient had a past medical history of thyroid nodule. Physical examination was unremarkable except the palpable thyroid mass. Esophagoscopy and esophagography revealed an intraluminal polypoid mass to the left of the cervical esophagus. Chest computed tomography showed round, homogenous, well-enhancing mass and calcifying thyroid nodule is found in front of the mass. Thyroid lobectomy and partial esophageal resection was performed. Microscopic finding showed typical features of thyroid papillary carcinoma. Metastatic thyroid papillary carcinoma should be included in the differential diagnosis of an intraluminal polypoid esophageal mass, particularly if the patient has a known thyroid tumor.
Carcinoma, Papillary* ; Diagnosis, Differential ; Esophagoscopy ; Esophagus* ; Hematemesis* ; Humans ; Physical Examination ; Thorax ; Thyroid Gland* ; Thyroid Nodule

Gastric carcinoid tumor is a rare neoplasm that occupies less than 1% of total gastric tumor. Especially, gastric carcinoid tumor with hemorrhage has been very rare. A sixty-three-year old male patient was admitted to the hospital because of hematemesis and melena. On the endoscopic examination, a 2 cm-long polypoid mass with central ulcer and hemorrhagic erosions was seen on the anterior wall of the mid-body without active bleeding. Endoscopic ultrasonography revealed that the lesion was limited to submucosa without evidence of metastasis to adjacent lymph node. We experienced a case of gastric carcinoid tumor accompanied with upper gastrointestinal bleeding. The patient underwent extended wedge resection and omentectomy under the diagnosis of type 3 carcinoid tumor. This tentative diagnosis was based on clinical and pathological findings. We report a case of gastric carcinoid with bleeding that is probably type 3.
Carcinoid Tumor* ; Diagnosis ; Endosonography ; Hematemesis ; Hemorrhage* ; Humans ; Lymph Nodes ; Male ; Melena ; Neoplasm Metastasis ; Ulcer

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

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.
Aged, 80 and over ; Aortic Aneurysm ; Diagnosis ; Emergencies ; Esophageal Fistula ; Fistula* ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Syncope