A rare case of penetration related to ischemic duodenitis after ventricular assist device implantation for dilated cardiomyopathy

Research output: Contribution to journalArticlepeer-review

Abstract

A 66-year-old man with a history of diabetes and dilated cardiomyopathy underwent the implantation of a ventricular assist device (VAD) at the age of 62. He suffered from epigastralgia for a month and then visited our hospital with complaints of severe epigastralgia and hematemesis. A physical examination revealed abdominal distension without rigidity. Laboratory data showed severe systemic inflammation, multiple organ failure, and disseminated intravascular coagulation. Computed tomography showed multifocal thickness of the gastroduodenal wall with surrounding panniculitis, gas in a portal vein and a perigastric vein. Emergency esophago-gastro duodenoscopy (EGD) demonstrated a large erosion in the antrum of the stomach, and penetration surrounded by circumferentially ischemic mucosa in the second and third portions of the duodenum. Based on informed consent, conservative therapy was performed, and his condition improved enabling the start of oral intake on the 37th hospital day. However, 7 days later, there was a relapse of epigastralgia after a meal. Gastrointestinal series and EGD revealed a 10-mm-long pinhole-like stricture at the site. After laparoscopic gastro-jejunal bypass surgery, he has remained in a good condition for 2 years. We demonstrated a rare case of penetration due to severe ischemic duodenitis 4 years after VAD implantation.

Original languageEnglish
JournalClinical Journal of Gastroenterology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Ischemic duodenal penetration
  • Ischemic duodenitis
  • Ventricular assist devise

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'A rare case of penetration related to ischemic duodenitis after ventricular assist device implantation for dilated cardiomyopathy'. Together they form a unique fingerprint.

Cite this