Duodenal Ulcer Associated with Exudative Esophagitis in a Patient with Gastrointestinal Bleeding: A Case Report

Úlcera duodenal associada à esofagite exsudativa em paciente com hemorragia digestiva: Relato de caso

Abstract

Peptic ulcer disease remains a major cause of upper gastrointestinal haemorrhage, particularly in patients with risk factors such as chronic alcohol consumption, Helicobacter pylori infection and prolonged use of anti-inflammatory drugs. The aim of this article is to report a clinical case of an unusual clinical association between a duodenal ulcer and exudative oesophagitis, involving multiple risk factors. This is a 52-year-old male patient from a suburban area with a history of chronic epigastric pain associated with alcohol consumption; over the preceding months, his condition had progressed to include melena, bloody diarrhoea, weight loss, odynophagia and black vomit. He was admitted with severe epigastric pain and signs of malnutrition and severe anaemia (Hb 6.9 g/dL). Upper gastrointestinal endoscopy revealed oesophagitis with whitish exudate and a duodenal ulcer at the bulb. Clinical management was initiated with an intravenous proton pump inhibitor, empirical antibiotic therapy in view of the possibility of H. pylori infection, sucralfate and supportive care; the patient’s clinical course was favourable and he was discharged for outpatient follow-up. Duodenal ulcer remains a significant cause of upper gastrointestinal haemorrhage, particularly in patients with associated risk factors. Early endoscopic diagnosis and the prompt initiation of appropriate drug treatment are essential for preventing serious complications and improving the clinical prognosis. Keywords: Peptic Ulcer; Gastrointestinal Hemorrhage; Endoscopy, Gastrointestinal; Anemia; Angola (Source: MeSH, NLM).