The 43-year-old man has histories chronic hepatitis B associated hepatocellular carcinoma and tongue cancer. For HCCs treatment, he had received partial hepatectomy and transcatheter arterial chemoembolization at other hospital.
Two days prior to this admission, he received second course of TACE at other hospital and was started on NSAID for pain control. But epigastric pain, heartburn, and anorexia progressed after discharge Even more, massive tarry stool occurred with dizziness. Hence, he was sent to our MER for help.
His initial vital signs showed TPR: 36.1/115/18 with BP: 79/48 mmHg. Initial Hb level was 3.8g/dL. He received emergent transfusion with packed RBC 8units. Urgent EGD study showed gastric ulcers with pigmented spots (Forrest IIc), but no active bleeder was found. After high dose PPI therapy for 3 days, second look EGD was arranged and showed as following images and clips.
義大醫院‧總機電話：07-615-0011‧07-952-0011 地址：82445高雄市燕巢區角宿里義大路1號
語音‧人工掛號專線：07-615-0900‧07-615-0911 週一至週五 07:30~16:30 週六 07:30~11:30
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