Year 2019 / Volume 111 / Number 3
Letter
Black stomach: acute gastric wall ischemia due to polycythemia of an unknown origin

248

DOI: 10.17235/reed.2018.5849/2018

Richard Azevedo, Flávio Pereira, Ana Caldeira,

Abstract
Acute ischemia of the gastric mucosa, resulting in a black stomach, is a very rare event given the blood supply of the stomach, with a rich collateral blood flow system. We present the case of a 65-year-old man, with polycythemia of unknown origin under investigation, presented to the emergency department with a history of diffuse abdominal pain and hematemesis. Blood tests revealed a hemoglobin level of 22 g/dL.Upper endoscopy revealed a black ulcerated gastric mucosa compatible with acute necrosis of the corpus and antrum of the stomach . Despite few cases described in the literature, many etiologic factors have been suggested. In this particular case, given the severe polycythemia and associated hyperviscosity, vascular compromise of the gastric blood vessels might have played a major role in the pathogenesis of the ischemic process.
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References
Santos T, Freitas C, Pinto-de-Sousa J. Gastric wall ischemia following massive gastric distension due to peptic pyloric stenosis: a case report. J Surg Case Reports. 2016;2016(2). doi:10.1093/jscr/rjw008.
Nunes G, Patita M, Fernandes V, et al. Paraesophageal hernia and gastric volvulus: an uncommon etiology of vomiting and upper gastrointestinal bleeding. Rev Esp Enferm Dig. 2017;109(4):294-295.
Sala-Hernandez A, Pous-Serrano S, Lucas-Mera E, et al. Acute transverse colon volvulus with secondary gastric isquemia. Case report. Rev Esp Enferm Dig. 2016;108(3):163-164. doi:10.17235/reed.2016.4024/2015.
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Azevedo R, Pereira F, Caldeira A. Black stomach: acute gastric wall ischemia due to polycythemia of an unknown origin. 5849/2018


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Publication history

Received: 30/07/2018

Accepted: 04/08/2018

Online First: 19/11/2018

Published: 04/03/2019

Article Online First time: 112 days

Article editing time: 217 days


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