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Haematemesis resulting from ischaemic strangulating intestinal obstruction
K Moissinac1, J Ponnampalam, B Chong Se To
1Hospital Kuala Lumpur, Malaysia.
Summary
Haematemesis, or vomiting blood, can signal intestinal strangulation in patients with bowel obstruction. Prompt surgical exploration is crucial for non-resolving obstruction, especially with concurrent bleeding.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Strangulating intestinal obstruction can cause gastrointestinal bleeding, but vomiting blood (hematemesis) is uncommon.
- Early diagnosis and surgical intervention are critical for favorable outcomes in intestinal obstruction.
Observation:
- A patient presented with hematemesis and clinical/radiological signs of small bowel obstruction.
- Initial upper endoscopy failed to identify the bleeding source.
- Clinical deterioration necessitated exploratory laparotomy.
Findings:
- Laparotomy revealed gangrenous strangulated small bowel due to adhesive obstruction.
- Concurrent hematemesis was noted in this case of strangulated obstruction.
Implications:
- Hematemesis in the context of intestinal obstruction may indicate strangulation.
- Deterioration in non-resolving intestinal obstruction mandates urgent surgical exploration.
- Concurrent hematemesis strengthens the indication for immediate surgical intervention in suspected intestinal strangulation.