Abnormal gastric bleeding: please don’t touch!

Excerpt

A 51-year-old man with chronic alcohol consumption was admitted to the intensive care unit (ICU) for severe hematemesis with hemorrhagic shock. The patient’s history revealed no use of anti-inflammatory drugs, and there were no signs of liver cirrhosis on clinical examination. After stabilization, the gastric endoscopy did not find varices, but showed an isolated ulcerated mass on the large gastric curvature (Fig. 1); no hemostatic treatment was given at this stage. A CT scan with intravenous contrast was directly performed and revealed a 5-cm pancreatic pseudocyst, most probably secondary to chronic alcoholic pancreatitis, eroding the stomach and fed by a branch of the splenic artery (Fig. 1). Treatment consisted on emergency splenic artery embolization.

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