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- Title
A Rare Cause of Gastrointestinal Bleeding in a 65-Year-Old Man with History of Polycythemia Vera.
- Authors
Aletaha, Najmeh; Hamid, Hoda; Yazdi, Niloofar Ayoobi; Taslimi, Reza; Shahbazkhani, Bijan; Moghadam, Pardis Ketabi
- Abstract
Polycythemia vera (PV) is classified as a myeloproliferative disorder (MPD). Such patients are prone to both thrombotic and hemorrhagic events. Although gastrointestinal (GI) bleeding is not a prominent manifestation of PV, it would be life threatening and necessitating hospital admission and blood transfusion if it occurs. GI hemorrhage in these patients may be due to Aspirin usage, peptic ulcer disease (PUD), acquired Von Willbrand disease, Dieulafoy lesion (DL), Mallory Weiss tear, and esophageal and gastric varices. DL is an enlarged, thick-walled artery in the muscularis mucosa with a small submucosal defect. In this case report, we describe a 65-year-old man with history of PV presented with a massive upper GI bleeding. After a therapeutic endoscopic hemostasis failure and reoccurrence of bleeding during hospital admission, an abdominal computed tomography (CT) was ordered, which revealed an aberrant artery originated from aorta directly into the stomach. An angiographic embolization was considered for the patient, which was successfully performed. Our patient was complicated by splenic infarction due to splenic collateral arteries embolization and the overwhelming thrombotic tendency of the patient himself due to the history of PV. Fortunately, our patient's signs and symptoms responded to supportive therapies and eventually he discharged well.
- Subjects
GASTRIC varices; ABDOMINAL aorta radiography; ABDOMINAL radiography; ANGIOGRAPHY; COMPUTED tomography; GASTROINTESTINAL hemorrhage; POLYCYTHEMIA vera; THERAPEUTIC embolization; DISEASE relapse; TREATMENT effectiveness; ENDOSCOPIC hemostasis; DISEASE complications
- Publication
Middle East Journal of Digestive Diseases, 2019, Vol 11, Issue 4, p226
- ISSN
2008-5230
- Publication type
Article
- DOI
10.15171/mejdd.2019.153