First Author: P.Kiryttopoulos GREECE
Co Author(s): M. Moschos A. Jaulim N. Antonopoulos E. Tzaferis P. Mitropoulos I. Chatziralli 0 0 0 0 0 0 0 0 0
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To present the case of a man, who exhibited recurrent episodes of subconjunctival haemorrhage (SCH) for about one year before the diagnosis of gastrointestinal haemorrhage due to adenocarcinoma of oesophagus, treated after restoration of haemorrhage and resection of the tumour.
1Department of Internal Medicine, General Hospital of Veroia, Veroia, Greece 2Laboratory of Electrophysiology, 1st Department of Ophthalmology, University of Athens, Athens, Greece 3Royal Derby Hospital NHS Foundation Trust, Derby, East Midlands, UK 4 2nd Eye Clinic, Ophthalmiatrion Athinon, Greece
A 57-year-old man was admitted to the hospital with extensive gastrointestinal bleeding and a history of intermittent episodes of melena during five days. His medical history, as well as family history was clear, and he received no medications.
Endoscopy revealed a 1.5 cm solid mass, extended at 35 cm from the incisors, which bled readily on touch. Biopsy specimens taken from the lesion confirmed the diagnosis of a well-differentiated grade II adenocarcinoma of the oesophagus in the context of Barrett’s oesophagus. There were no signs of distant metastasis on pre-operative work-up. The patient reported only the presence of recurrent SCH during the last year and thorough ophthalmological examination, as well as work-up for hematological conditions or clotting disorders were performed, all being normal. The patient underwent radical oesophagectomy and reconstruction with gastric tube, as well as two-field lymph node dissection. Histopathology of the lesion revealed adenocarcinoma stage T1N0M0. Three years later he presented no symptoms, nor recurrence of the tumour. In addition, he never developed SCH during the three-year follow-up.
Recurrent SCH may be an indication of gastrointestinal bleeding and should not be underestimated by ophthalmologists or other clinicians, as it can reveal severe pathology.