%0 Journal Article
%T Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report
%A Mohammad Khan
%A Muhammad Baqai
%A Mohammad Baqai
%A Naveed Mufti
%J World Journal of Emergency Surgery
%D 2009
%I BioMed Central
%R 10.1186/1749-7922-4-15
%X A 30 years old female, 12 weeks pregnant was referred to our hospital from the earth-quake affected area of Kashmir with history of upper abdominal pain, haematemesis and melaena for one week. After stabilizing the patient, upper gastro-intestinal endoscopy was performed. It revealed gastric ulcer just distal to the gastro-esophageal junction on the lesser curvature. Biopsy from the ulcer edge led to profuse spurting of the blood and patient went into state of shock. Immediate resuscitation led to rebleeding and recurrence of post haemorrahagic shock.The patient was immediately explored and total gastrectectomy with splenectomy concluded as life saving procedure. A review of literature was conducted to make this report possible.Gastrointestinal bleeding is a commonly encountered emergency. Common causes include bleeding peptic ulcers, gastric erosions and esophageal varices. Rare causes include arteriovenous malformation (AVM) of the gastrointestinal tract. With increasing availability of endoscopy and elective angiography AVM is being more frequently recognized. Literature search shows since 1884 about 42 cases have been reported so far worldwide. Upper GI bleeding caused by AVM usually presents as massive haematemesis or chronic iron deficiency anaemia. Non-specific endoscopic appearances make the diagnosis difficult. Therapeutic embolisation offers a better chance of stopping hemorrhage. However, in emergency situations, surgeon may be forced to perform life saving exploration and procedures if selective angiography is not available or unhelpful and when patient with AVM causing massive haemorrhage required surgical arrest of bleeding.A 30 years old lady with 12 weeks gestational amenorrhea was referred to our hospital with history of upper abdominal pain, haematemesis and melaena for last one week. After stabilization upper gastro- intestinal endoscopy was performed. It revealed lesion resembling gastric ulcer on the lesser curvature just distal to gastro- oesop
%U http://www.wjes.org/content/4/1/15