Open-and-Shut Case: An Uncommon Cause of Gl Bleeding

摘要

Case Presentation and Evolution: A 48-year-old man was initially evaluated in the emergency department after acute onset of melena and syncope. He had a self-reported history of attention deficit hyperactiv-ity disorder (ADHD), for which he was not receiving treatment, and methamphetamine use, but his urine toxicology was negative for amphetamines on admission. Moreover, he was actively drinking alcohol, averaging one pint of vodka per day, having consumed alcohol on the day of admission. Prior to the onset of melena, the patient had 2 weeks of epigastric pain without vomiting or hematemesis. He denied a prior history of liver disease, coagulopathy, or gastrointestinal (GI) bleeding.