title: Massive GI bleeding due to accidental ASA inhalation.
abstract: This report describes a 38-year-old man admitted to hospital for a massive rectal bleeding and syncope. He was known to have idiopathic thrombocytopenia but he had never complained of bleeding until he was admitted to hospital with uncontrolled hemorrhage. Upper and lower endoscopic examination, performed 6 hours after occurrence of bleeding, were negative for ulcers or other bleeding lesions. However, capsule endoscopy did detect diffuse areas of petechial hemorrhage and erosions in the small bowel. Thromboelastography performed on the day of admission showed a marked decrease in platelet aggregation rate, that normalized two days after. The patient recovered with conservative treatment only. Thorough questioning did not evidence relevant events apart from inhalation of a massive quantity of acetylsalicylic acid: the patient, working as a farmer, had prepared, without protection, fodder for the animals containing a great amount of acetylsalicylic acid. Bleeding had started few hours thereafter. After recovery, bleeding did not recur despite persistent thrombocytopenia.
authors.affiliation: Gastroenterology and Hepatology Unit, Policlinico di Modena, Modena, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Bianchini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cavina
authors.forename: Valentina
authors.initials: V
authors.lastname: Boarino
authors.forename: Bruno
authors.initials: B
authors.lastname: Begliomini
authors.forename: Nicola
authors.initials: N
authors.lastname: De Maria
authors.forename: Erica
authors.initials: E
authors.lastname: Villa
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000821:Animal Feed; D000818:Animals; D001241:Aspirin / Q000008:administration & dosage / Q000506:poisoning; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000506:poisoning; D013552:Swine; D013916:Thrombelastography
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin