Hyperbaric oxygen therapy in the treatment of severe gastric laceration with active bleeding: A case report.

Abstract

Background: Endoscopic therapy is the primary approach for treating Mallory-Weiss syndrome, particularly under conditions of mucosal protection and gastric acid suppression. However, for a subset of patients who cannot undergo endoscopic intervention or for whom such treatment proves ineffective, alternative measures like arterial embolization or surgical intervention may be required. While hyperbaric oxygen therapy (HBOT) has been applied across a range of medical conditions, its application in managing hemorrhage due to gastric tears remains undocumented.

Case summary: A 52-year-old patient was admitted with symptoms of hematemesis and melena, and an endoscopy revealed a gastric fundus tear approximately 4 cm × 5 cm in size. The lesion was considered unsuitable for endoscopic repair by the attending endoscopist. Despite conservative measures, including fasting and acid suppression, the patient experienced persistent bleeding and a substantial decrease in hemoglobin levels relative to admission values. Following a multidisciplinary consultation, HBOT was initiated, resulting in the cessation of bleeding and rapid wound healing.

Conclusion: For patients with gastric tears presenting with active hemorrhage, HBOT might offer an effective alternative when conventional endoscopic therapies are not viable or have been unsuccessful.