Gastric Endoscopy Treatment with Tissue Adhesive Proves Effective for 27-Year-Old Man with Upper Gastrointestinal Bleeding

In this article, we explore the successful treatment of a 27-year-old male suffering from upper gastrointestinal bleeding. The patient experienced melena four times within three days and was admitted with symptoms of fatigue and dizziness. Following a thorough medical evaluation and endoscopic procedure, his condition improved significantly with a combination of tissue adhesive therapy and medication. This case highlights the importance of timely diagnosis and appropriate intervention in managing digestive tract conditions.

Understanding the Patient Profile and Diagnosis

The patient was a 27-year-old male working in the IT industry. He had a history of irregular eating habits and frequent late-night work sessions. His primary symptoms were black, tarry stools and fatigue. Blood tests revealed a hemoglobin level of 76g/L, indicating moderate anemia. Emergency gastroscopy identified a 0.5cm ulcer in the duodenal bulb with an exposed clot, leading to a diagnosis of bleeding duodenal ulcer and erosive gastritis.

Treatment Plan and Medical Intervention

Given the clear diagnosis, the medical team opted for endoscopic treatment using cyanoacrylate tissue adhesive to seal the ulcer and stop the bleeding. The patient was advised to fast and was given intravenous ilaprazole to suppress gastric acid secretion. Additional medications included snake venom thrombin for hemostasis and oral drugs such as teprenone, amoxicillin, bismuth potassium citrate, and metronidazole to support healing and prevent infection. The patient was closely monitored for any signs of ongoing bleeding, and the importance of blood transfusion was discussed if necessary.

Positive Recovery and Follow-Up

Following the treatment, the patient's symptoms improved significantly. His fatigue and dizziness subsided, and no further episodes of melena were observed. A follow-up blood test showed his hemoglobin level had increased to 88g/L. He was gradually reintroduced to a liquid diet and eventually transitioned to regular meals. By the seventh day, his stool had returned to normal color, and he was discharged with a prescription for continued eradication therapy for Helicobacter pylori. A month later, a gastroscopy confirmed complete healing of the duodenal ulcer.

Post-Treatment Care and Lifestyle Adjustments

While the patient's condition improved, it is crucial to emphasize the importance of lifestyle modifications to prevent recurrence. Young individuals, particularly those under high stress and with irregular schedules, are more prone to peptic ulcers. Dietary advice included avoiding spicy or irritating foods and opting for bland, easily digestible meals. Maintaining a consistent sleep schedule and avoiding late nights were also emphasized. Any signs of upper abdominal discomfort, acid reflux, or bloating should prompt a visit to the doctor. Immediate medical attention is necessary if symptoms like melena, hematemesis, or severe abdominal pain occur, as these may indicate complications such as bleeding or perforation.

Clinical Insights and Preventive Measures

Upper gastrointestinal bleeding is a common condition in gastroenterology, with peptic ulcers accounting for nearly half of all cases. This patient's condition was strongly linked to poor lifestyle habits, including irregular eating patterns and lack of sleep. Ulcer-related bleeding is a serious complication that requires prompt treatment with proton pump inhibitors and mucosal protectants. Testing and treating Helicobacter pylori infection is also a key component of management. In more severe cases, endoscopic intervention or even surgical treatment may be necessary. Preventive strategies should focus on maintaining a healthy lifestyle, eating regular meals, and managing stress effectively.