Unusual cause of upper gastrointestinal bleed, when OGD could be fatal
| Autor: | Satyanisth Agrawal, Robin Midian, Elie Aoun, Raman Khehra |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Thorax medicine.medical_specialty Gastrointestinal bleeding Radiofrequency ablation Fistula Chest pain Article law.invention Esophageal Fistula Fatal Outcome Pneumocephalus law Atrial Fibrillation medicine Humans Heart Atria Coma Coffee ground vomiting business.industry Atrial fibrillation General Medicine Middle Aged medicine.disease Heart Arrest Surgery cardiovascular system medicine.symptom Gastrointestinal Hemorrhage Tomography X-Ray Computed business |
| Zdroj: | BMJ Case Reports. :bcr2015210804 |
| ISSN: | 1757-790X |
| Popis: | A 57-year-old man presented with chest pain, dyspnoea and coffee grounds emesis. He was haemodynamically stable without significant drop in haemoglobin. He suddenly developed cardiac arrest with wide complex tachycardia and became comatose. CT scan of the head revealed pneumocephalus and multiple infarcts. Given the recent history of radiofrequency ablation for atrial fibrillation, atrio-oesophageal fistula (AOF) was suspected. CT angiography of the thorax showed a 5 mm diverticulum on the posterior wall of the left atrium, also raising suspicion for AOF. The patient was taken to the operating room. An AOF was found and repaired. He did not have any further gastrointestinal bleeding. There was no neurological recovery at day 11 and life support was withdrawn per his family's request. This case highlights the importance of obtaining history of recent cardiac procedures in patients presenting with an upper gastrointestinal bleed. An oesophagogastroduodenoscopy in this patient could have been instantaneously deadly. |
| Databáze: | OpenAIRE |
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