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World Journal of Gastroenterology Oct 2021Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare primary intestinal T-cell lymphoma, previously known as enteropathy-associated T-cell lymphoma... (Review)
Review
BACKGROUND
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare primary intestinal T-cell lymphoma, previously known as enteropathy-associated T-cell lymphoma type II. MEITL is an aggressive T-cell lymphoma with a poor prognosis and high mortality rate. The known major complications of MEITL are intestinal perforation and obstruction. Here, we present a case of MEITL that was diagnosed following upper gastrointestinal bleeding from an ulcerative duodenal lesion, with recurrence-free survival for 5 years.
CASE SUMMARY
A 68-year-old female was admitted to our hospital with melena and mild anemia. An urgent esophagogastroduodenoscopy (EGD) revealed bleeding from an ulcerative lesion in the transverse part of the duodenum, for which hemostatic treatment was performed. MEITL was diagnosed following repeated biopsies of the lesion, and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy was administered. She achieved complete remission after eight full cycles of CHOP therapy. At the last follow-up examination, EGD revealed a scarred ulcer and Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography showed no abnormal FDG accumulation. The patient has been in complete remission for 68 mo after initial diagnosis.
CONCLUSION
To rule out MEITL, it is important to carefully perform histological examination when bleeding from a duodenal ulcer is observed.
Topics: Antineoplastic Combined Chemotherapy Protocols; Biopsy; Cyclophosphamide; Doxorubicin; Enteropathy-Associated T-Cell Lymphoma; Female; Humans; Lymphoma, T-Cell; Melena; Positron Emission Tomography Computed Tomography; Vincristine
PubMed: 34720538
DOI: 10.3748/wjg.v27.i38.6501 -
Gastrointestinal Endoscopy Jan 2021
Topics: Adult; Biopsy; COVID-19; Duodenal Diseases; Endoscopy, Gastrointestinal; Humans; Male; Melena; SARS-CoV-2; Thrombosis
PubMed: 32682813
DOI: 10.1016/j.gie.2020.07.010 -
British Medical Journal Oct 1965
Topics: Aged; Diagnosis, Differential; Female; Gastrectomy; Hematemesis; Hernia, Diaphragmatic; Humans; Male; Melena; Middle Aged; Peptic Ulcer Hemorrhage; Prognosis; Statistics as Topic; Stomach Neoplasms
PubMed: 5889795
DOI: 10.1136/bmj.2.5465.781 -
ACG Case Reports Journal Jul 2023
PubMed: 37426567
DOI: 10.14309/crj.0000000000001081 -
La Clinica Terapeutica 2023Double pylorus is one of the rare endoscopic findings consisting of two communication channels between the gastric antrum and the first part of the duodenum. It has no...
Double pylorus is one of the rare endoscopic findings consisting of two communication channels between the gastric antrum and the first part of the duodenum. It has no specific signs and symptoms. It is usually detected incidentally during endoscopic examination performed with nonspecific dyspeptic complaints such as epigastric pain, nausea, vomiting, and bloating. But contrary to expectations our patient applied to the emergency department with the complaint of melena that had been going on for 3 days. Her hemoglobin value was 9.7 mg/dL, blood ure nitrogen value was 65 mg/dL. Rectal touch examination was compatible with melena. In the emergency endoscopy of the patient, two channels were seen in the pylorus region. In the accessory canal, there was an ulcer of 10 mm in size with adherent dots and white exudate. The biopsy was reported as chronic gastritis due to H.pylori infection. Ibuprofen treatment used by the patient was discontinued and the patient was given high double dose PPI and H.pylori eradication therapy. Double pylorus, which is usually found incidentally in endoscopy with nonspecific findings, may very rarely present with GI bleeding findings, as in our patient. It is necessary to avoid risk factors in double pylorus, to give antiulcer and H.pylori treatment in its presence for an optimal time regardless of whether the double pylorus continues or not.
Topics: Female; Humans; Pylorus; Melena; Gastrointestinal Hemorrhage; Helicobacter Infections; Risk Factors; Helicobacter pylori
PubMed: 36655637
DOI: 10.7417/CT.2023.5001 -
Canadian Family Physician Medecin de... Nov 1995Acute gastrointestinal hemorrhage is a common problem that requires prompt recognition and management to prevent serious morbidity and mortality. Management goals are... (Review)
Review
Acute gastrointestinal hemorrhage is a common problem that requires prompt recognition and management to prevent serious morbidity and mortality. Management goals are stabilization of the patient with vigorous fluid resuscitation followed by investigation and definitive treatment of the bleeding source. Endoscopy is often the initial diagnostic test and allows therapeutic measures to be performed at the same time.
Topics: Acute Disease; Combined Modality Therapy; Diagnosis, Differential; Endoscopy, Gastrointestinal; Gastrointestinal Hemorrhage; Humans; Melena; Resuscitation
PubMed: 8563510
DOI: No ID Found -
Cureus Dec 2023Liposarcoma is the most prevalent malignant soft tissue tumor and is primarily found in extremities and retroperitoneum, but its occurrence within abdominal viscera is...
Liposarcoma is the most prevalent malignant soft tissue tumor and is primarily found in extremities and retroperitoneum, but its occurrence within abdominal viscera is rare. Most of these cases have been reported in the esophagus and stomach. Among liposarcomas of the gastrointestinal tract, primary duodenal liposarcomas are exceptionally rare, with only five documented cases in the literature. We describe a case of a 66-year-old female presenting with syncope, melena, and anemia. Computed tomography (CT) showed soft tissue mass involving the superior wall of the duodenum and hypo-enhancing hepatic mass. An endoscopy was performed, which revealed a duodenal mass causing gastric outlet obstruction and significant bleeding. Therefore, laparotomy was performed with extensive lysis of adhesions and gastrojejunostomy.
PubMed: 38259374
DOI: 10.7759/cureus.50978 -
Surgical Case Reports Jun 2020We encountered a case of marginal ulcer in the jejunum after distal gastrectomy with jejunal pouch interposition. However, it has not been reported and not confirmed the...
BACKGROUND
We encountered a case of marginal ulcer in the jejunum after distal gastrectomy with jejunal pouch interposition. However, it has not been reported and not confirmed the treatment. We chose truncal vagotomy, considering reduced morbidity and postoperative complications.
CASE PRESENTATION
A case was a 69-year-old woman who was admitted to our hospital with melena. She had received curative distal gastrectomy with a 15-cm jejunal pouch reconstruction for early gastric cancer. Marginal ulcer in the jejunal pouch was detected by upper gastrointestinal endoscopy. She was given medication; however, she repeated hospitalization for melena and abdominal pain. Therefore, we decided to perform surgery, and truncal vagotomy was performed. The patient's postoperative course was uneventful and was discharged on the 22nd postoperative day. Symptoms such as abdominal pain and melena were improved after truncal vagotomy.
CONCLUSION
We presented a case with a complicated peptic ulcer after distal gastrectomy with reconstruction by jejunal pouch interposition, which was successfully treated by truncal vagotomy, a surgical acid-reducing procedure which does not require resection of remnant stomach.
PubMed: 32488527
DOI: 10.1186/s40792-020-00879-w -
Pakistan Journal of Medical Sciences Mar 2014Pyeloduodenal fistula is a rare condition and its association with malignancy is even rarer. Herein we report the case of a 66-year-old man who was admitted to the...
Pyeloduodenal fistula is a rare condition and its association with malignancy is even rarer. Herein we report the case of a 66-year-old man who was admitted to the hospital with a three-month history of intermittent melena and a more than 20-year history of right-side renal stones. Computed tomography showed a heterogeneous right renal mass with a staghorn stone that had invaded the duodenum and caused an internal fistula. An upper gastrointestinal series showed pyeloduodenal fistula. The patient underwent an exploratory operation and a biopsy was taken at the peripelvic region. Pathological examination verified the existence of squamous cell carcinoma. To our knowledge, this is the first case of pyeloduodenal fistula associated with renal stones, squamous cell carcinoma and upper urinary tract calculus presenting on melena. We report on the features of this rare entity but also review and summarize the etiology, diagnosis and treatment options that can be extrapolated from the existing literature.
PubMed: 24772159
DOI: No ID Found -
Acute Medicine & Surgery 2020Epistaxis is a common condition that can sometimes be overlooked. It usually presents with obvious symptoms but could also present as hematemesis and melena.
BACKGROUND
Epistaxis is a common condition that can sometimes be overlooked. It usually presents with obvious symptoms but could also present as hematemesis and melena.
CASE PRESENTATION
A 78-year-old man presented to our emergency department with melena and shock. Initial endoscopy revealed a bleeding gastric ulcer. However, he had recurrent episodes of hematemesis and melena following coagulation therapy, and a repeat esophagogastroduodenoscopy could not identify the source of bleeding for more than 1 week. Epistaxis from nasal polyps was identified as the cause of hemorrhagic shock. Posterior nasal packing was carried out with Foley catheters, and an endoscopic sinus surgery was finally performed.
CONCLUSION
We report a case of epistaxis that caused hematemesis and melena following gastrointestinal bleeding. The diagnosis of epistaxis might have been delayed due to anchoring bias. Clinicians should be aware that epistaxis can mimic upper gastrointestinal bleeding and remember this important differential diagnosis.
PubMed: 31988763
DOI: 10.1002/ams2.451