Successful endoscopic vacuum therapy in diffuse gastric hemorrhage secondary to acute ischemia: a case report

Acute gastric ischemia is rare and may lead to diffuse mucosal bleeding, often refractory to conventional endoscopic therapy. We describe the case of a 42-year-old critically ill burn patient who developed persistent upper gastrointestinal hemorrhage unresponsive to medical treatment, in whom the novel use of endoscopic vacuum therapy (EVT) was undertaken. Serial endoscopies demonstrated progressive mucosal healing, reduced necrosis, and effective bleeding control. EVT promoted granulation tissue and ulcer healing, avoiding surgical intervention. No EVT-related adverse events occurred. Despite successful hemostasis, the patient later died from a sepsis-related adverse event. In conclusion, this case illustrates EVT as a viable and effective approach for managing refractory diffuse gastric bleeding secondary to ischemia. EVT may offer a minimally invasive alternative to surgery in critically ill patients where standard therapies fail.