Cases reported "Melena"

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11/13. Diffuse vascular ectasia of the gastric antrum.

    Diffuse vascular ectasia of the gastric antrum may present as occult gastrointestinal blood loss and iron-deficiency anemia. Four patients are described with iron-deficiency anemia in whom characteristic lesions were found at endoscopy. As in previous reports, lesions are either angioid linear streaking of the antrum with convergence at the pylorus ("watermelon stomach") or diffuse, well-demarcated erythematous areas. biopsy with the electrocautery forceps may show dilated ectatic mucosal vessels often containing fibrin thrombi which will establish a diagnosis. Standard biopsy techniques failed to make a diagnosis in two of the three patients in which it was attempted. Medical therapy consisted of iron replacement and transfusion as needed. In three of the four cases, symptomatic anemia recurred and required antrectomy for management of the anemia. The antrectomy specimens revealed ectatic mucosal and submucosal vessels with a fibrotic pattern involving the lamina propria. This pattern has been previously reported. One patient was treated with corticosteroids transiently with resolution of her anemia. The endoscopic appearance of this entity may mimic antral gastritis and needs to be considered in the differential diagnosis of iron-deficiency anemia from chronic gastrointestinal blood loss.
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ranking = 1
keywords = blood loss
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12/13. Recurrent intestinal haemorrhages caused by a lipoma in the ileocaecal valve in a patient with Von Willebrand's disease.

    Lipomas of the digestive tract are rare and may give rise to obstruction, intussusception or haemorrhage. In a 74-year old woman with Von Willebrand's disease, a lipoma in the ileocaecal valve caused frequent intestinal haemorrhages and chronic anaemia over a period of more than 15 years. diagnosis and therapy are discussed on the basis of the case history.
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ranking = 0.68674221338475
keywords = haemorrhage
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13/13. An unusual presentation of an unusual complication of infectious mononucleosis: haematemesis and melaena.

    Tonsillar haemorrhage is a rare complication of infectious mononucleosis. We present a case of life-threatening tonsillar haemorrhage secondary to infectious mononucleosis in a young man whose predominant symptoms at presentation were haematemesis and melaena. The origin of the haemorrhage was not obvious until the patient was examined under anaesthesia. The bleeding was controlled by emergency tonsillectomy.
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ranking = 0.34337110669237
keywords = haemorrhage
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