Case report

Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report

Mohammad Iqbal Khan¹ , Muhammad Tariq Baqai² , Mohammad Fahd Baqai³ and Naveed Mufti⁴

¹  Department of surgery, Islamic International Medical College, Rawalpindi, Pakistan

²  Department of medicine, Islamic International Medical College, Rawalpindi, Pakistan

³  Department of medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

⁴  Department of Obs & Gynae, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

author email corresponding author email

World Journal of Emergency Surgery 2009, 4:15doi:10.1186/1749-7922-4-15

Published:	1 May 2009

Abstract

Background

In this paper we are reporting one case of exsanguinating upper gastrointestinal tract (GIT) bleed requiring massive blood transfusion and immediate life saving surgery.

Case presentation

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.

Conclusion

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.