Year 2024 / Volume 116 / Number 4
Letter
An unpredictable gastrointestinal bleed

226-227

DOI: 10.17235/reed.2023.9659/2023

De-Feng Li, Yan-Hui Tian, Rui-Yue Shi, Jun Yao, Li-Sheng Wang, Zheng-Lei Xu,

Abstract
A 65-year-old male complained of persistent melena for 6 days, and displayed anemia symptoms without hematemesis, vomiting, and abdominal distention. He was diagnosed as ruptured aneurysm of aortic sinus Valsalva, and had received coronary artery occlusion 1 month ago. After the operation, he was continually prescribed clopidogrel 75 mg once daily. The laboratory examination showed blood hemoglobin concentration was 60 g/L without other conspicuous abnormality. Unfortunately, neither esophagogastroduodenoscopy (EGD) nor colonoscopy found no obvious bleeding lesions. And abdominal computed tomography angiography (CTA) and enhanced computed tomography (CT) showed no obvious abnormal findings. Moreover, capsule endoscopy revealed small intestinal with mucosal erosion (Figure 1A). After discontinued clopidogrel, blood transfusion, and support therapy, his symptoms was resolved with negative fecal occult blood, continued clopidogrel 75 mg once daily, and uneventfully discharged 1 week later.
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References
1. Sakai E, Ohata K, Nakajima A, et al. Diagnosis and therapeutic strategies for small bowel vascular lesions. World J Gastroenterol 2019;25:2720-2733.
2. Chetcuti Zammit S, Koulaouzidis A, Sanders DS, et al. Overview of small bowel angioectasias: clinical presentation and treatment options. Expert Rev Gastroenterol Hepatol 2018;12:125-139.
3. Mazahreh TS, Aleshawi AJ, Alorjani MS, et al. Arteriovenous malformations within jejunal diverticulosis: case report and literature review. BMC Surg 2019;19:70.
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Li D, Tian Y, Shi R, Yao J, Wang L, Xu Z, et all. An unpredictable gastrointestinal bleed. 9659/2023


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Publication history

Received: 12/04/2023

Accepted: 14/04/2023

Online First: 28/04/2023

Published: 09/04/2024

Article Online First time: 16 days

Article editing time: 363 days


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