A Rare Encounter: Gastric Ulcer Penetration into the Splenic Hilum Presenting with Upper Gastrointestinal Bleeding and a Massive Splenic Haematoma-Case Report and Literature Review.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-03-04 DOI:10.3390/diagnostics15050617
Ioana-Irina Rezuș, Vasile-Claudiu Mihai, Diana Elena Floria, Andrei Olteanu, Vlad Ionut Vlasceanu, Radu Petru Soroceanu, Alin Constantin Pinzariu, Brigitta Teutsch, Sergiu Tudose-Timofeiov
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Abstract

Background: Despite advancements in prevention and treatment, peptic ulcer disease (PUD) remains a public health burden, with potentially high mortality rates when not managed properly. Recent studies indicate bleeding as the most prevalent complication, followed by perforation or penetration into adjacent organs and pyloric obstruction. In rare cases, posterior wall or greater curvature ulcers of the stomach can penetrate, leading to splenic artery pseudoaneurysms. With nonspecific symptoms and low incidence, it is highly important that these entities are not overlooked in the diagnosis of patients with upper gastrointestinal bleeding. Case Report: We present the case of a 44-year-old patient presenting for upper abdominal pain and haematemesis while being haemodynamically stable. Emergency ultrasound described a dysmorphic spleen, with a transonic image with a Doppler signal in the splenic hilum. Upper gastrointestinal tract endoscopy detected a blood-filled stomach, without the possibility of identifying the bleeding source. The CT scan revealed active bleeding with peri splenic haematoma. Intraoperatively, a posterior gastric wall penetration into the spleen was identified, and an atypical gastric resection and caudal splenopancreatectomy were performed. The postoperative course was marked by the identification of a staple line leak in the upper pole of the stomach, which was treated conservatively, with a favourable outcome, and the patient was discharged after two weeks. Conclusions: Upper gastrointestinal tract haemorrhage needs fast intervention and suitable management. The multidisciplinary team plays a key role in identifying and treating rare causes such as penetration into the splenic hilum.

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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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