Al Neelain Medical Journal - VOL -20

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CASE REPORT; AN EARLY & URGENT ENDOSCOPY MAY AFFECT THE PROGNOSIS IN PATIENT WITH SUSPECTED CORROSIVE INGESTION
(جامعة النيلين - مركز النيلين الطبي, 2017-04)
ABSTRACT 29 years female presented with sudden onset severe abdominal pain, mainly epigastric associated with bouts of bloody stained vomitus. The patient denied history of taking neither non-steroidal anti-inflammatory drugs nor any other substance. The patient was stable at the emergency department with normal physical examination and basic investigations. Hence she was admitted for elective upper gastrointestinal endoscopy. The condition of the patient deteriorated due to marked unexplained massive blood loss. Hence an urgent blood transfusion was commenced and the patient shifted to the intensive care unit for stabilization and close monitoring. Then urgent endoscopy conducted at the intensive care unit showed findings consistent with a severe caustic mucosal injury of the lower oesophagus and the stomach. These findings paved the road for the correct diagnosis and initiation of the proper management. It could be concluded that an urgent endoscopy should be done as earlier as possible in patients who present with unexplained severe upper gastrointestinal bleeding to confirm the diagnosis and initiate a proper management to reduce the severity of acute complications, improve the prognosis and achieve a better outcome.