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Esophageal ulcer and multisystem inflammatory syndrome after COVID-19: A case report.

World J Gastrointest Endosc

August 2024

Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital University of Medical Science, Beijing 100020, China.

Background: Multisystem inflammatory syndrome in adults (MIS-A) is a rare but severe disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 infection. It develops in adults with inflammation of different organs including the gastrointestinal tract, heart, kidneys, skin and hematopoietic system.

Case Summary: We present a 58-year-old Chinese man diagnosed with MIS-A.

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Article Synopsis
  • VA-ECMO techniques have advanced and are particularly beneficial for patients with reversible low cardiac output, such as the case of a 21-year-old male with congenital heart disease who experienced severe shock following an upper gastrointestinal bleed.
  • Initial treatments included intubation, fluid resuscitation, and emergency endoscopy to control active bleeding, but the patient's condition worsened, leading to the need for VA-ECMO support due to severe ventricular dysfunction and high lactate levels.
  • After optimizing care in the ICU and adjusting ventilation strategies, the patient's condition stabilized, allowing for extubation and the discontinuation of certain medications, reflecting a positive recovery trajectory.
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The mortality rate of gastric varices bleeding can reach 20% within 6 weeks. Isolated gastric varices (IGVs) refer to gastric varices without esophageal varices and typically arise as a common complication of left portal hypertension. Although IGVs commonly form in the setting of splenic vein occlusion, the combination of antiphospholipid syndrome and protein S deficiency leading to splenic vein occlusion is rare.

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A 73-year-old man underwent pancreatoduodenectomy 5 years previously, and portal vein stenosis was observed immediately after surgery. A collateral vein with varices around the hepaticojejunostomy gradually developed. The patient experienced repeated episodes of melena that required transfusion.

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Multiple gastrointestinal stromal tumors (GISTs) combined with cutaneous multiple neurofibromas are clinically rare. This paper presents a case of multiple gastrointestinal stromal tumors in the jejunum of a 68-year-old mother, along with her daughter who also had coexisting cutaneous multiple neurofibromas. The mother had been experiencing repeated melena for over 2 years and had previously been diagnosed with multiple small intestinal masses at other hospitals.

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