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Gastric ischaemia: a rare cause of gastric ulcers
  1. Arunima Dutta1,
  2. Laxman Yashwant Byreddi1,
  3. Kavitha Kesari2 and
  4. Priyanka Buchupalle3
  1. 1Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
  2. 2Internal Medicine, McLaren Health Care Corp, Flint, Michigan, USA
  3. 3Internal Medicine, CHRISTUS Good Shepherd Health System, Longview, Texas, USA
  1. Correspondence to Dr Arunima Dutta; dutta.arunima29{at}gmail.com

Abstract

Gastric ulcers secondary to gastric ischaemia is rare because of the rich blood supply of the stomach. We present a case where a patient with history of atherosclerotic vascular disease (ASCVD) presented with unintentional weight loss and failure to thrive for several months. Initial imaging studies ruled out any active malignancy. Oesophagogastroduodenoscopy revealed multiple shallow gastric ulcers. CT angiography was performed in later course of the hospital stay, which demonstrated a high-grade stenosis at the origin of both the superior mesenteric artery and the coeliac trunk. This combination stenosis is a rare finding, which can lead to ischaemia of the stomach by blocking the stomach’s dual blood supply. Although the patient underwent revascularisation attempt with stent placement, she expired due to critical postoperative condition. This case signifies the importance of keeping a low threshold for suspicion for gastric ischaemia in patients with ASCVD risk factors and unexplained weight loss.

  • gastrointestinal system
  • ulcer
  • stomach and duodenum
  • vascular surgery
  • gastrointestinal surgery

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Footnotes

  • Twitter @Arunima_dutta

  • Contributors AD conceived the idea of writing the case report. AD and LYB did the literature search. All authors discussed the literature findings and contributed to the final manuscript. AD wrote the manuscript with support from LYB and PB. KK supervised the project. KK provided expert opinion while drafting the manuscript. All authors reviewed, discussed and provided critical feedback to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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