A previously healthy 81-year-old man was admitted to our
hospital with weakness and fatigue caused by anemia. Laboratory
studies were notable for a red-cell count of 1,580,000 per
ml, a hemoglobin level of 4.8 g per deciliter, and hematocrit
level of 15.1 %. Emergency endoscopic examination revealed
an active gastric ulcer.
Two days later, mild epigastric tenderness was present. Computed
tomography of the abdomen revealed hepatic portal
venous gas and massive gastric submucosal hematoma.
however, there was no evidence of perforation. Four days after
conservative treatment, on follow-up computed tomography,
neither gastric submucosal hematoma nor hepatic portal venous gas was observed (Panel C). Recovery was uneventful
and the patient was well discharged on the 20th hospital day.
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