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Pseudoxanthoma elasticum with recurrent gastric hemorrhage managed by endoscopic mechanical hemostasis
Author(s) -
Nishiyama Hitoshi,
Mizuta Yohei,
Isomoto Hajime,
Kadokawa Yoshiko,
Kanazawa Yusei,
Takeshima Fuminao,
Omagari Katsuhisa,
Fukuda Yasuhiro,
Murata Ikuo,
Kohno Shigeru
Publication year - 2004
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2003.00328.x
Subject(s) - medicine , submucosa , hemostasis , pseudoxanthoma elasticum , radiology , gastrointestinal bleeding , surgery , endoscopy
A 24‐year‐old‐woman was admitted to our hospital for further examination of recurrent upper gastrointestinal tract hemorrhage. The characteristic xanthomatous papular rash, retinal angioid streaks, and stenosis of cardiac coronary artery confirmed the diagnosis of pseudoxanthoma elasticum. Upper gastrointestinal endoscopy revealed vascular dilation in the gastric body to fornix. The vessel showing conspicuous dilation covered with the discolored mucosa was suspected as the source of the bleeding. The vessel was identified as a dilated vein located in the submucosa by endoscopic ultrasonography and pulsed‐wave Doppler ultrasonography. Abdominal angiography demonstrated aneurysmal dilation in the splenic artery, but not in the gastric artery. Endoscopic band ligation was chosen as an initial treatment for the prevention of recurrent bleeding. The procedure seemed to be successful, but rebleeding occurred on the next day, which was again treated with hemostatic clipping. There have been no further episodes of gastrointestinal hemorrhage during the 15‐month follow up.