Promising way to address massive intragastric clotting in patients with acute upper gastrointestinal bleeding:A case report  

作　　者：Su-Xian Liu Bei Shi Ya-Feng Liu Jing-Yi Shan Bo Sun 

机构地区：[1]Department of Gastroenterology,Longhua Affiliated Hospital of Shanghai Traditional Chinese Medicine,Shanghai 210000,China

出　　处：《World Journal of Clinical Cases》2023年第15期3578-3582,共5页世界临床病例杂志

基　　金：Supported by Natural Youth Science Foundation of China,No.82104743;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Innovation Project,No KY2056.

摘　　要：BACKGROUND Massive intragastric clotting(MIC) makes endoscopic therapy difficult in patients with acute upper gastrointestinal bleeding. Literature data on how to address this problem are limited. Here, we report on a case of massive stomach bleeding with MIC that was successfully treated endoscopically using an overtube of singleballoon enteroscopy.CASE SUMMARY A 62-year-old gentleman with metastatic lung cancer was admitted to the intensive care unit due to tarry stools and hematemesis of 1500 mL of blood during hospitalization. Emergent esophagogastroduodenoscopy revealed massive blood clots and fresh blood in the stomach with evidence of active bleeding.Bleeding sites could not be observed even by changing the patient’s position and aggressive endoscope suction. The MIC was successfully removed using an overtube connected with a suction pipe, which was inserted into the stomach with an overtube of a single-balloon enteroscope. An ultrathin gastroscope was also introduced through the nose into the stomach to guide the suction. A massive blood clot was successfully removed, and an ulcer with oozing bleeding at the inferior lesser curvature of the upper gastric body was revealed, facilitating endoscopic hemostatic therapy.CONCLUSION This technique appears to be a previously unreported method to suction MIC out of the stomach in patients with acute upper gastrointestinal bleeding. This technique could be considered when other methods are not available or if they fail to remove massive blood clots in the stomach.

关 键 词：Upper gastrointestinal bleeding Massive intragastric clotting Overtube for single-balloon enteroscope Ultrathin gastroscope Case report 

分 类 号：R573.2[医药卫生—消化系统]