Author: ERAMO Annarita, Roma, Italy

A 81-year-old woman presented to the Emergency Department with coffee-ground emesis and epigastric pain. Her past medical history was notable for hypertension and she was taking low-dose aspirin for primary prevention. Upper GI endoscopy revealed mottled gastric mucosa with alternating pale and reddish areas in the antrum, easily bleeding although low CO2 insufflation, as well as bluish congested folds in the corpus. These findings suggested ischemic gastropathy. A contrast-enhanced CT scan confirmed the diagnosis, showing coeliac trunk occlusion associated with gastric hypoperfusion. High dose IPP were initiated. The patient was subsequently referred to interventional radiology and vascular surgery for further management.