2008 Volume 19 Issue 5 Pages 288-292
A 60-year-old male patient with tube feeding, suffering from quadriplegia by a high spinal cord injury, had changed to a gastrostomy catheter button. Two weeks later he had to be admitted to our critical care center, for support for developed anemia, melena, vomiting, and abdominal distention. The gastroduodenoscopy on admission revealed a gastric linear ulcer just under the cardia, and so we diagnosed it as Mallory-Weiss syndrome (M-W synd). However we could not see abdominal distention and discover the reason for it. On hospital day 5, via a second gastroduodenoscopy, we could see that a migration of the balloon had caused a pyloric obstruction, resulting in the distension of the epigatrium. It is uncommon for the migration of balloons to gives pyloric obstruction in a patient with a gastrostomy catheter button. Furthermore, it is unique that a pyloric obstruction causes M-W synd. Medical physicians should be careful about the possibility of a pyloric obstruction causing M-W synd.
