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Upper gastrointestinal bleeding in a patient with AIDS
Valeska Balderas1, Stuart Jon Spechler
1University of Texas Southwestern Medical Center, Dallas, TX, USA.
Background:
A 38-year-old man with AIDS and hepatitis C was admitted to our hospital in January 2005, with complaints of epigastric pain, odynophagia, and melena of 4 days' duration. The patient was not taking highly active antiretroviral therapy because of poor compliance and he denied use of NSAIDs.
Investigations:
Physical examination, stool guaiac test, laboratory investigations, and esophagogastroduodenoscopy with biopsies of gastric ulcerations.
Diagnosis:
Non-Hodgkin's lymphoma of the stomach (diffuse large B-cell type) with associated gastric ulceration and bleeding.
Management:
Injection of epinephrine and bipolar coagulation for the bleeding malignant ulcer, and PPI therapy.
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