A Rare Case of COVID-19 Pneumonia Concomitant with Bleeding from Acute Gastric Mucosal Lesions

Hideaki Kawabata; Katsutoshi Yamaguchi; Yuki Ueda; Ryo Shinomiya; Yuji Okazaki; Tetsuya Yamamoto; Kojiro Nakase; Masatoshi Miyata; Shigehiro Motoi; Yasuyuki Enoki; Tetsuhiro Minamikawa

doi:10.2169/internalmedicine.7803-21

CASE REPORTS

A Rare Case of COVID-19 Pneumonia Concomitant with Bleeding from Acute Gastric Mucosal Lesions

Hideaki Kawabata, Katsutoshi Yamaguchi, Yuki Ueda, Ryo Shinomiya, Yuji Okazaki, Tetsuya Yamamoto, Kojiro Nakase, Masatoshi Miyata, Shigehiro Motoi, Yasuyuki Enoki, Tetsuhiro Minamikawa

Author information

Hideaki Kawabata
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Katsutoshi Yamaguchi
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Yuki Ueda
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Ryo Shinomiya
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Yuji Okazaki
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Tetsuya Yamamoto
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Kojiro Nakase
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Masatoshi Miyata
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Shigehiro Motoi
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Japan
Yasuyuki Enoki
Department of Pathology, Kyoto Okamoto Memorial Hospital, Japan
Tetsuhiro Minamikawa
Department of Pathology, Kyoto Okamoto Memorial Hospital, Japan

Keywords: coronavirus disease 2019, COVID-19, gastrointestinal bleeding, acute gastric mucosal lesion

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 21 Pages 3421-3426

DOI https://doi.org/10.2169/internalmedicine.7803-21

Details

Abstract

A 70-year-old man was diagnosed with coronavirus disease 2019 (COVID-19) pneumonia. Twenty-six days after admission, he experienced hematemesis despite improvement in his respiratory symptoms. Contrast-enhanced computed tomography revealed edematous stomach wall thickening with neither ischemic findings in the gastric wall nor obstruction of the gastric artery. Emergent esophagogastroduodenoscopy showed diffuse dark-red mucosa accompanied by multiple easy-bleeding, irregularly shaped ulcers throughout almost the whole stomach without active bleeding or visible vessels. The clinical course, including the endoscopic findings, progressed favorably with conservative treatment. COVID-19 pneumonia can present with acute gastric mucosal lesion, which may be induced by microvascular thrombosis due to COVID-19-related coagulopathy.

Corresponding author

Register with J-STAGE for free!