{
  "abstract": "A patient in his early 70s presented to our emergency department with haematemesis, fatigue, fever and pallor. Clinical examination revealed low blood pressure (80/50 mm Hg), tachycardia (120/min), pallor, decreased consciousness and fever. The patient’s oxygen saturation was 86% and with 4 L/min of oxygen 95%. Laboratory investigations indicated anaemia (haemoglobin 81 g/L) and elevated inflammatory markers (leucocytes 13.74 /nL, C reactive protein 188 mg/L, procalcitonin 19.3 ng/mL). Medical history for dyspepsia, peptic ulcer disease or use of non-steroidal anti-inflammatory drugs was negative. The patient was transferred to the intensive care unit, where he received vasopressors to maintain normal blood pressure. No blood transfusion was required. To prevent aspiration pneumonia and to safely perform endoscopy, the patient was endotracheally intubated. Oesophagogastroduodenoscopy showed ulcerative duodenitis starting from the duodenal bulb and extending to the descending part of the duodenum ( figure 1A–D, arrows). A bleeding ulcer was endoscopically treated using a through-the-scope clip (figure 1E,F, arrows). To perform Campylobacter-like organism (CLO) test, histopathological and microbiological examinations, biopsies were taken from the descending part of the duodenum, the gastric antrum and the corpus. Since the CLO test was negative, the patient did not receive treatment for Helicobacter pylori.",
  "authors": [
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Patricia Mester"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Laura Drösch"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Stephan Schmid"
    },
    {
      "affiliations": [
        "Institute of Pathology, University of Regensburg, Regensburg, Germany"
      ],
      "name": "Florian Weber"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Arne Kandulski"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Martina Müller"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious diseases, University Hospital Regensburg, Regensburg, Germany"
      ],
      "name": "Vlad Pavel"
    }
  ],
  "title": "Haematemesis in an elderly patient",
  "uid": "04183240-d24c-56cb-b0d2-49b13c070bde"
}