Haematemesis in Ménétrier's disease

Dickinson, Rebecca; Axon, A. T. R.

doi:10.1136/pgmj.55.648.751

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…MD, being a rare disease, was very difficult to diagnose and needed the surgical specimen to come to a definitive diagnosis in this case. The usual symptoms are epigastric pain (65%), fatigue (60%), anorexia (45%), weight loss (45%), vomiting (38%), and edema (38%) due to the protein loss, but our patient presented an upper GI bleed that led to severe anemia and congestive heart failure, which is a rare complication [1][2][3][4][5][6]. A very rare presentation of this disease is gastroduodenal intussusception [7].…”

Section: Discussionmentioning

confidence: 78%

“…On endoscopy, MD shows enlarged gastric folds usually spare antrum, surface erosions, and copious amounts of thick mucus may form bridges across the gastric lumen and might obscure visualization [ 1 , 3 ]. Bjork et al defined an enlarged gastric fold as measuring > 1 cm by radiology and that persists after air insufflation on endoscopy [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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The Great Mimicker of Gastric Cancer: A Case Report of Ménétrier's Disease

Roy,

Neogi,

Chaturvedi

et al. 2024

Cureus

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This is the case of a 52-year-old Indian lady who presented with hematemesis, severe anemia, and an abdominal lump in cardiac failure. On radiographic evaluation, the lesion appeared to be gross circumferential asymmetric proximal gastric wall thickening, with suspicion of gastric lymphoma or tubercular hypertrophic gastritis. After stabilization with multiple transfusions, she underwent proximal D2 gastrectomy with esophago-gastric anastomosis and a total splenectomy. Grossly, the gastric rugae appeared to be hypertrophied and firm. No growth was identified grossly; however, necrotic areas were identified at the distal end. Microscopic examination of multiple sections studied showed significant foveolar hyperplasia, tortuous glands, and a few cystically dilated foveolar glands, which were limited up to the muscle layer. Mild serosal congestion was seen. No atypia or invasion was seen. An impression to consider is the possibility of Ménétrier’s disease (MD). MD is an acquired protein-losing enteropathy with giant gastric rugal folds, decreased acid secretion, and increased gastric mucous production. Radiographically, endoscopically, and grossly, the condition can be confused with malignant lymphoma or carcinoma. It is difficult to diagnose, and histopathological confirmation of the resected specimen is needed for a definitive diagnosis. Our intention in presenting this case is to emphasize that MD can present as massive hematemesis and should be considered in a differential diagnosis. Surgical treatment by total or partial gastrectomy is recommended for cases with persistent, debilitating symptoms or a risk of cancer.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

The Great Mimicker of Gastric Cancer: A Case Report of Ménétrier's Disease

Roy,

Neogi,

Chaturvedi

et al. 2024

Cureus

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“…Upper gastrointestinal bleeding has been reported as a rare manifestation of Ménétrier’s disease. The bleeding may present as hematemesis or, like in this case, as melena[ 10 , 11 ]. One patient developed deep vein thrombosis and received anticoagulation therapy, which led to gastrointestinal bleeding[ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma: A case report

Kmiecik¹,

Walczak²,

Samborski³

et al. 2023

World J Gastrointest Endosc

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BACKGROUND Ménétrier’s disease is a rare condition characterized by enlarged gastric folds, usually located in the whole body and fundus of the stomach. This report presents an unusual case of localized Ménétrier’s disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding. The mass was successfully removed with endoscopic submucosal dissection. CASE SUMMARY Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding, manifesting as fatigue and melena. A large polypoid mass (4 cm × 1 cm) with enlarged mucosal folds was found in the body of the stomach, between the lesser curvature and posterior wall. A small ulcer at the distal end of the mass was identified as the source of the bleeding. Biopsy was negative for neoplasia. Computed tomography showed a submucosal lesion beneath the affected mucosa, most likely a lipoma. The mass was removed en bloc with tunneling endoscopic submucosal dissection. Final pathology determined that the mass included Ménétrier’s disease and a submucosal lipoma. The patient was scheduled for follow-up esophagogastroduodenoscopy. CONCLUSION Localized Ménétrier’s disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.

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“…It has been said to be due to prolapsing of the mucosa through the pylorus. In 4 previously reported cases, severe haematemesis was the indication for emergency surgery (Dickinson and Axon, 1979;Singh et al, 1979). Occult bleeding is more common and, in T.S.…”

Section: Discussionmentioning

confidence: 99%

The diagnosis of Ménétrier’s disease

Ward

Sarner

Whittaker

et al. 1981

Postgraduate Medical Journal

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Two cases of Ménétrier's disease are reported to illustrate the clinical presentation and diagnosis of this unusual condition. The literature has been reviewed of all the reported cases to establish the relative importance of the individual symptomatology, the value of the diagnostic methods, and to highlight the diagnostic pitfalls. Recognition of the barium meal appearances and snare biopsy at gastroscopy may avoid the necessity of diagnostic laparotomy.

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Haematemesis in Ménétrier's disease

Cited by 5 publications

References 4 publications

The Great Mimicker of Gastric Cancer: A Case Report of Ménétrier's Disease

The Great Mimicker of Gastric Cancer: A Case Report of Ménétrier's Disease

Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma: A case report

The diagnosis of Ménétrier’s disease

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