A rare cause of acute upper gastrointestinal bleeding

Acute upper gastrointestinal bleeding (AUGB) remains a common indication for admissions and is associated with significant morbidity and mortality. Peptic ulcer diseases and varices are the commonest lesions identified during endoscopy. However, endoscopists need to be aware of the rare causes of AUGB, as missing such lesions can potentially be fatal. Rare causes can be missed if they are not looked for systematically during endoscopy. We report a case of AUGB secondary to bullous pemphigoid involving the esophagus in an elderly gentleman presenting with significant blood loss from hematemesis. A review of the English literatures on bullous pemphigoid involvements of the esophagus was carried out and the underlying pathogenesis and management are discussed.