In Menetrier's disease, the gastric mucosal hypertrophy is so great aht rugae looks like convolutions of the brain. Although this gross appearacne is common to all cases of Meneterier's disease, ither the gastric glandular elements or the
superficial
epithelial elements may predominate; acid secretion may be high, normal, or low; and hypoproteinemia may or may not be present.
There is no consensus about which of these features define the disease. the main abnormality is a remarkable hyperplasia of the mucous surface and foveolar cells, but it's pathogenesis and pathophysiology are poorly understood.
Menetrier's discase is rarely cited as a cause of hematemesis, although this complication is recognized and should be considered in any dase of hematemesis in which rugal hypertrophy is found at gastrofiberscopy or upper gastrointestinal series
(UGIS).
Recently, we experienced a 37 year old man who presented with massive hematemesis and hypoproteinemia. Menetrier's disease was suggested by laboratory findings, gastrofiberoscopy and UGIS. Massive UGI bleeding had repetitively occurred five times
in
spite of conservative management, so total gastrectomy was performed.
The pathologic findings are consistent with those of Menetrier's disease such as thichened hyper plastic mucosa of the gastric fundus with characteristic cystic dilatation of the deeper crypts.
Thereafter, the patient have recovered in good general condition and UGI bleeding was stopped. We present a rare case of Menetrie's disease associated with masive UGI bleeding and a brief review of clinical and pathologic pictures and management.
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