Author: Valeria D'OVIDIO Roma Italy

A 74-year-old woman was admitted to the Emergency Department for hematemesis and melena with severe anemia, which occurred after repeated episodes of vomiting. The anamnesis included multiple comorbidities (obesity, revascularized ischemic heart disease, paroxysmal atrial fibrillation on Apixaban + Clopidogrel, type II insulin-dependent diabetes mellitus, previous breast cancer).

After hemodynamic stabilization, blood transfusions, and orotracheal intubation, the patient underwent gastroscopy, which revealed a longitudinal mucosal laceration from the cardiac region to the middle third of the esophagus. An endoscopic band ligation was performed on two emerging blood vessels, while the remaining part of the laceration was treated with injection of adrenaline and closure of the breach with metal clips.

Hemostasis was stable at follow-up. The patient survived the acute episode without further complications and gradually resumed a normal diet

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