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• W3211174920 abstract "Introduction: Pseudomelanosis gastri or gastric pseudomelanosis is an extremely rare endoscopic mucosal finding that has been reported on few occasions in the literature. We present a case of an incidental finding of extensive gastric and duodenal pseudomelanosis in an elderly female with symptomatic anemia. Case Description/Methods: A 71-year-old female with history of heart failure, diabetes mellitus, coronary artery disease, atrial fibrillation, hepatitis C, iron deficiency anemia, ovarian cancer and malignant peritoneal mesothelioma presented with lethargy and anorexia. Physical examination was remarkable for an epigastric mass and digital rectal exam revealed dark brown stool. Laboratory studies were notable for Hb 4.4, BUN 70, Cr 5.9 and elevated transaminases. Outpatient medication included eliquis, insulin, rosuvastatin, isordil, entresto, hydralazine, aspirin, amiodarone and iron supplementation. She received two units of blood and responded appropriately. CT abdomen/pelvis was significant for metastatic disease and a previously unchanged large pelvic mass. Esophagogastroduodenoscopy revealed patchy and diffuse discoloration in the gastric body and duodenum with no evidence of active bleeding or high-risk stigmata of bleeding. (Figure 1) Pathology was consistent with a diagnosis of pseudomelanosis in the stomach and duodenum with evidence of chronic atrophic gastritis. The patient’s hemoglobin remained stable and her Eliquis was held. With no evidence of active bleeding, she was discharged with plans for follow up in the outpatient setting for further evaluation with colonoscopy. Discussion: While the etiology is not well defined, pseudomelanosis of the upper gastrointestinal tract is classically associated with bleeding, diabetes mellitus, end stage renal disease, antihypertensives such as hydralazine and oral iron take. Our case had numerous risk factors that are suggested to cause pseudomelanosis and while duodenal involvement has been well described there have been very few cases reporting the presence in both the stomach and duodenum. Pseudomelanosis is a benign condition of no known clinical significance however it is important for an endoscopist to be aware of this entity as it can appear very similar to malignant melanoma on both endoscopy and histology and therefore must be differentiated. It may also become a more common finding due to an aging population with multiple comorbidities on medication associated with the diagnosis and thus must be recognized.Figure 1.: Gastric Pseudomelanosis." @default.
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• W3211174920 date "2021-10-01" @default.
• W3211174920 modified "2023-09-27" @default.
• W3211174920 title "S3579 A Rare Case of Gastric and Duodenal Pseudomelanosis" @default.
• W3211174920 doi "https://doi.org/10.14309/01.ajg.0000787848.74133.a6" @default.
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