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Massive upper GI bleeding: a rare complication of Zenker's diverticulum
1Department of Surgery A, Meir Medical Center, Kfar Sava, affiliated to the faculty of Medicine, Tel-Aviv University, Israel.
Journal of Postgraduate Medicine
|July 16, 2008
Summary
Massive hematemesis from a Zenker's diverticulum is rare but can be life-threatening. This case suggests aspirin may cause ulcerations within the diverticulum, leading to severe bleeding, especially in elderly patients.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Background:
- Zenker's diverticulum is a rare cause of upper gastrointestinal bleeding.
- Massive hematemesis necessitates urgent investigation and management.
Observation:
- A 71-year-old male presented with massive hematemesis.
- Endoscopy was obscured by blood clots; CT angiography revealed contrast blush from the diverticulum.
- Surgical exploration identified a deep ulcer within the diverticulum as the bleeding source.
Findings:
- The precise cause of the ulceration remains unknown.
- Aspirin ingestion is hypothesized as a potential direct cause of the ulceration.
- This represents a rare but potentially fatal complication of Zenker's diverticulum.
Implications:
- Highlights a possible life-threatening complication of Zenker's diverticulum in patients using aspirin.
- Emphasizes the need for vigilance in patients with Zenker's diverticulum on aspirin therapy.
- Suggests considering diverticular ulceration in patients with unexplained GI bleeding while on aspirin.
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