Upper Gastrointestinal Tract Hemorrhage: Unexpected Discovery.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Radiology

Background:

• Pica is a disorder characterized by the persistent ingestion of non-nutritive, non-food substances.
• This condition can lead to severe gastrointestinal complications, including obstruction and bleeding.
• Diagnosis often occurs incidentally during surgical exploration for related symptoms.

Observation:

• A 64-year-old male presented with upper GI bleeding, epigastric pain, and constipation.
• Computed tomography revealed hyper-dense stomach contents, gastric wall thickening, and ascites, without bowel obstruction.
• Laparotomy identified a large quantity of ingested pebbles and a stenotic tumor on the lesser gastric curvature.

Findings:

• The patient underwent total gastric resection with esophagojejunal and entero-entero anastomosis.
• Histopathology revealed a hemorrhagic and stenotic tumor.
• Postoperative recovery was uneventful, with imaging confirming a functional anastomosis.

Implications:

• This case underscores the critical importance of comprehensive preoperative evaluation in patients presenting with symptoms suggestive of pica.
• Prompt diagnosis and surgical intervention are vital for managing complications arising from ingested foreign bodies and associated pathologies.
• Increased awareness and diagnostic vigilance are necessary to prevent delayed diagnosis of pica-related gastrointestinal emergencies.