A rare cause of upper GI bleeding and wasting disease

Clinical presentation A 74-year-old Turkish woman was admitted with loss of appetite, weight loss and progressive anaemia. Her medical history included rheumatoid arthritis, type 2 diabetes and end-stage renal disease with nephrotic syndrome diagnosed 2 years ago. Endoscopy of the upper GI tract revealed a distinct intramural gastric haematoma with diffuse, seeping haemorrhage and large gastric intraluminal blood clots (figure 1A, B; online supplementary films 1 and 2). The mucosa appeared partly necrotic, and the gastric wall showed a sponge-like consistence and marked vulnerability. An abdominal CT scan was performed. Question What is the underlying condition leading to the endoscopic and CT findings? See page 881 for answer See page 787 for question Answer CT scan showed gastric and rectal wall thickening of up to 2 cm (figure 1C, D). Histology of the gastric tissue revealed amyloid plaque depositions leading to the...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research