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Gastric Tube Ulcer that Could Be Saved by Early Conservative Treatment.

Authors :: Koyama M
Shiba H
Takakura K
Yamahata Y
Otsuka S
Odaka M
Takagi K
Takano Y
Eto K
Source :: Case reports in gastroenterology [Case Rep Gastroenterol] 2022 Jun 13; Vol. 16 (2), pp. 357-361. Date of Electronic Publication: 2022 Jun 13 (Print Publication: 2022).
Publication Year :: 2022
Abstract: The patient was an 81-year-old man who had received subtotal esophagectomy for esophageal cancer reconstructed by a gastric tube via a posterior mediastinal route. He presented to our emergency room with a complaint of epigastric pain and a small amount of hematemesis. Thoracoabdominal computed tomography showed that the reconstructed gastric tube was filled fluid and had irregular wall thickening. We suspected upper gastrointestinal bleeding, and we started to treat with administration of proton pump inhibitors (PPIs) since the anemia was mild and his vitals were stable. However, his anemia was rapidly progressed to Hb 6.0 with a large amount of old blood melena. The emergency gastroscopy showed an A2 stage ulcer with active oozing at middle esophagus reconstructed by a gastric tube. Therefore, we applied thrombin spray to treat the bleeding. Fortunately, his recovery was progressing nicely with medical treatments for a week. In this study, we experienced a case in which early administration of PPIs might be a key player to prevent his medical condition worsened further.<br />Competing Interests: The authors have no conflicts of interest to declare.<br /> (Copyright © 2022 by S. Karger AG, Basel.)