Case presentation A 78-year-old woman was brought to the emergency department after collapsing following several episodes of fresh hematemesis with melena. Medical and surgical history The patient suffered from severe pulmonary hypertension, type 2 diabetes mellitus, bronchiectasis, and ischemic heart disease. She had no history of any gastroenterological disease. She had undergone uncomplicated total hip replacement three weeks back for osteoarthritis and was under NSAIDs for analgesia.
Esophagogastroduodenoscopy The patient responded well to the initial resuscitative measures to undergo esophagogastroduodenoscopy. The procedure had to be aborted since the gastroenterologist could not view the stomach or the duodenum due to excessive hemorrhage. The patient went into a state of hypovolemic shock and had to be intubated and ventilated. Laparotomy and antrotomy with duodenotomy No…
