2020 Volume 56 Issue 4 Pages 388-391
The present case concerns a 3-year-old boy. Four days before visiting our hospital, the patient had common cold symptoms and was prescribed the appropriate medication by his family physician. After the occurrence of vomiting and tarry stool, he was referred to our hospital. His hemoglobin (Hb) level was 11.3 g/dl, and he was positive for fecal occult blood. He was therefore admitted for close observation and treatment. The day after admission, his complexion became poor and his Hb level decreased to 6.3 g/dl. Abdominal computed tomography (CT) revealed gastric wall thickening and a 4-cm-long cystic mass in the fornix of the stomach. Emergency blood transfusion was performed, followed by upper gastrointestinal endoscopy under general anesthesia. An active ulcer associated with a submucosal tumor was found in the gastric fornix, and hemostasis was initiated. If the bleeding could not be controlled with proton-pump inhibitors, the plan was to remove the gastric mass to achieve hemostasis. After treatment, the melena stopped and the patient maintained a Hb level of 11.0 g/dl. On the 12th day, endoscopic ultrasonography performed to examine the submucosal tumor revealed that the tumor became smaller and that the ulcer had scarred during healing. Six months after the melena stopped, follow-up endoscopy showed that the ulcer had healed and that no elevated lesion was evident. The first CT was reviewed and the CT value was considered to indicate hematoma in the submucosal area of the stomach.
