An unusual cause of dyspepsia: oesophageal cavernous haemangioma

Abstract

A 73-year-old gentleman presented to his local general practitioner with a sudden onset history for 24 h of dyspepsia. The symptoms were exacerbated with food over the period. He was referred to the medical assessment unit at The Horton Hospital, Banbury, UK. His medical history included: hypertension (on enalapril) and asthma (on a salbutamol inhaler as required). He was a retired construction manager who had worked for a long period in The Middle East and Japan. He took 2–3 cans of beer and 2–3 glasses of wine per week. He had been noted to have longstanding mildly abnormal liver function tests 12 years prior to admission with a predominantly elevated γ-GT. A chronic liver disease screen and ultrasound arranged previously at a private clinic had been unremarkable. In the medical assessment unit, clinical examination was unremarkable. His blood tests (including a Troponin to exclude significant cardiac event), electrocardiograph and chest X-ray were normal. He was started on a proton pump inhibitor with an outpatient gastroscopy requested. A gastroscopy was carried out 2 weeks later performed by a general practitioner (GP) endoscopist with the squamocolomnar junction seen at 36 cm with a 4-cm hiatus hernia. An abnormal …