Hematemesis due to double sources: a case report of epistaxis following gastric ulcer

Posterior Epistaxis Presenting as Upper GI Bleeding in A Healthy 21-Year-Old Patient: A Case Report

A 21-year-old Palestinian woman experienced recurrent hematemesis and melena over 7 months, requiring multiple hospital admissions and blood transfusions. Despite extensive investigations, the bleeding source remained undetermined until a posterior nasal bleed was suspected. Flexible rhinoscopy revealed a dilated sphenopalatine artery, and she was successfully treated with endovascular intervention. It is important for the Gastroenterologists to consider nasal endoscopy for patients with unexplained UGIB.

Anti-Tubercular-Therapy-Induced Severe Thrombocytopenia Presenting as a Vocal Cord Bleed With Massive Hemoptysis Causing Mortality: A Catastrophic Combination

Severe thrombocytopenia induced by anti-tubercular therapy (ATT) is a rare but potentially life-threatening complication. Severe thrombocytopenia is a known adverse effect of ATT, but its association with fatal hemoptysis is rare. Hematemesis and hemoptysis are two serious symptoms that indicate bleeding from the upper gastrointestinal and the lower respiratory tract, respectively. We report a rare case of a 65-year-old man, a diagnosed case of tuberculosis on ATT, who presented with massive hemoptysis. On navigating the bleed, the source was found to be a vocal cord bleed, which further led to massive clot formation in the left bronchus, leading to the collapse of the subsequent lung, leading to mortality. This case emphasizes the importance of recognizing ATT as a potential cause of bleeding and considering causes of massive hematemesis that are not gastrointestinal. It also highlights the need for a thorough evaluation of the airway in such patients.