Endoscopic Findings of Oozing Gastric Hamartomatous Polyps: A Rare Cause of Upper Gastrointestinal Bleeding

Abstract

Gastric hamartomatous polyps are infrequent benign lesions of the stomach, typically discovered incidentally during endoscopy. Upper gastrointestinal bleeding (UGIB) is a commonly encountered medical emergency, often caused by peptic ulcers, esophageal varices, or gastritis. However, in some rare instances, the bleeding source may be attributed to gastric hamartomatous polyps. The authors here present a case of a 64-year-old male patient who presented with generalised weakness, dizziness, loss of appetite, and constipation. Laboratory tests revealed microcytic hypochromic anaemia. Stool for occult blood was positive. Initial evaluation, including laboratory tests and imaging studies, was inconclusive for the source of the UGIB. Therefore, endoscopy was performed, which revealed multiple small sessile polyps of approximately 0.5-1cm in the body of the stomach along the greater curvature, which were oozing blood spontaneously. Histopathological examination of the polyps revealed their hamartomatous nature. The patient was diagnosed as a case of chronic constipation with microcytic hypochromic anaemia with hamartomatous gastric polyp. The bleeding was successfully controlled through endotherapy with endoscopic injection of epinephrine (1:10,000) injected at the site of the ooze. Due to the rarity of this condition, the diagnosis was challenging and required a high index of suspicion. Physicians should consider this entity in the differential diagnosis of UGIB. This case highlights the importance of considering hamartomatous polyps as a potential source of UGIB and demonstrates the efficacy of endoscopic treatment for both diagnosis and management. Awareness of this rare entity can aid in prompt recognition and appropriate therapeutic interventions to prevent potential life-threatening complications.

Keywords

• endotherapy
• benign
• microcytic hypochromic anaemia