Gastric cat-scratch, atypical location of a rare complication. About a case

The cat scratch injury consists of the appearance during endoscopy of mucosal lacerations longitudinal, bright red, distributed circumferentially, which do not usually cause significant hemorrhage. It is mainly attributed to barotrauma due to air insufflation during the procedure. They have been described mainly in the colon, being much less frequent in the stomach and esophagus. It is related to abnormal mucosa (collagen alteration, NSAID intake, metabolic myopathy, shunt colitis). We present a case of a 23 years-old male with a history of esophageal impaction that gets admitted at our emergency room with hematemesis and melena after taking NSAID for two days. During the introduction of the endoscope a duodenal fibrotic ulcer was observed (Forrest III). In withdrawal and retroversion, several mucosal tears are observed longitudinal in gastric body and with a radial arrangement around cardias. These lesions present drooling bleeding that gives way spontaneously. The findings are related to barotrauma and the exploration is suspended due to the risk of further iatrogenic. After 48 hours of close observation, the patient is discharged [1] [2] [3].

The case described is a rare complication, with and atypical location and only a few cases about this are published. In all of those, biopsies were taken with irrelevant histological findings. Although the definitive etiology is unknown, barotrauma due to air insufflations has been a frequent cause.

Publication History

Article published online:
27 March 2025

• References

• 1 Antolín Melero B, Alcaide Suárez N, Burgueño Gómez B, Fernández Salazar L.. Cat scratch esophagus. Rev Esp Enferm Dig 2019; 111 (11): 881
• 2 Baudet JS, Arguiñarena X, Díaz-Bethencourt D, Soler M, Avilés J.. Colon en arañazo de gato. Una entidad poco conocida Cat scratch colon. A little known condition]. Rev Esp Enferm Dig 2008; 100 (12) 790-1 Spanish doi:10.4321/s1130-0108200800120001019222340.
• 3 Carvalho TM, Fernandes VM, de Freitas JM.. Gastric cat scratch--an upper endoscopy finding?. J Gastrointestin Liver Dis 2014; 23 (4): 361