Edoxaban
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Aggravation of underlying bleeding from a gastric lipomatous lesion: case report A 93-year-year-old man developed aggravation of underlying bleeding from a gastric lipomatous lesion during anticoagulant therapy with edoxaban. The man was receiving anticoagulant therapy with edoxaban [route and dosage not stated]. Subsequently, he presented to the emergency department with haematemesis, decreased appetite and lethargy. He was then hospitalised. The man was treated with fluid resuscitation. Thereafter, upper gastrointestinal endoscopy was performed, which revealed a large submucosal lesion with ulceration and oozing blood in the gastric fundus. He was treated with adrenaline and haemospray resulting in endoscopic haemostasis. However, clips could not be placed due to the size of the ulcer. An initial provisional diagnosis of a gastrointestinal stromal tumour was made. However, CT scan displayed a fungating mass arising from the fundus of the stomach, which was of fat density. He was conservatively treated. Edoxaban was discontinued. Thereafter, no recurrence of bleeding was observed. He was discharged. He was diagnosed with bleeding from a large gastric lipomatous lesion due to extensive ulceration into the mucosa. The bleeding was suspected to have been aggravated by edoxaban therapy [duration of treatment to reaction onset not stated]. Hashim A, et al. Images of the month 2: A rare case of haematemesis from a gastric submucosal lesion. Clinical Medicine (London, England) 19: 414-415, No. 5, Sep 2019. 803445221 Available from: URL: http://doi.org/10.7861/clinmed.2019-0184
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Reactions 11 Jan 2020 No. 1786
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