Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising

A 65-year-old female patient with dermatomyositis and lipodystrophy presented with fatigue and severe anemia. Abdominal auscultation revealed a loud hum in the epigastrium, consistent with a Cruveilhier-Baumgarten murmur, typically associated with portal hypertension. Magnetic resonance imaging show...

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Main Authors: Maria Mironova, Nadera Altork, Harish Gopalakrishna, David E. Kleiner, Theo Heller
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Gastro Hep Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772572325001013
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author Maria Mironova
Nadera Altork
Harish Gopalakrishna
David E. Kleiner
Theo Heller
author_facet Maria Mironova
Nadera Altork
Harish Gopalakrishna
David E. Kleiner
Theo Heller
author_sort Maria Mironova
collection DOAJ
description A 65-year-old female patient with dermatomyositis and lipodystrophy presented with fatigue and severe anemia. Abdominal auscultation revealed a loud hum in the epigastrium, consistent with a Cruveilhier-Baumgarten murmur, typically associated with portal hypertension. Magnetic resonance imaging showed signs of portal hypertension, including recanalization of paraumbilical vein. Liver biopsy demonstrated sinusoidal dilation without cirrhosis, leading to a diagnosis of portosinusoidal vascular disease. Upper endoscopy confirmed portal hypertensive gastropathy as the cause of anemia. This case highlights the importance of a thorough physical examination in guiding subsequent imaging and diagnostic workup.
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publishDate 2025-01-01
publisher Elsevier
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series Gastro Hep Advances
spelling doaj-art-32273dfda28e45029ab2ff4e92f6bcda2025-08-20T02:46:25ZengElsevierGastro Hep Advances2772-57232025-01-014910071410.1016/j.gastha.2025.100714Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and BruisingMaria Mironova0Nadera Altork1Harish Gopalakrishna2David E. Kleiner3Theo Heller4Translational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MarylandMedStar Health/Georgetown-Washington Hospital Center, Washington, District of ColumbiaTranslational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MarylandLaboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MarylandTranslational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland; Correspondence: Address correspondence to: Theo Heller, MD, Translational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Building 10, Room 4-5722, Bethesda, MD 20892.A 65-year-old female patient with dermatomyositis and lipodystrophy presented with fatigue and severe anemia. Abdominal auscultation revealed a loud hum in the epigastrium, consistent with a Cruveilhier-Baumgarten murmur, typically associated with portal hypertension. Magnetic resonance imaging showed signs of portal hypertension, including recanalization of paraumbilical vein. Liver biopsy demonstrated sinusoidal dilation without cirrhosis, leading to a diagnosis of portosinusoidal vascular disease. Upper endoscopy confirmed portal hypertensive gastropathy as the cause of anemia. This case highlights the importance of a thorough physical examination in guiding subsequent imaging and diagnostic workup.http://www.sciencedirect.com/science/article/pii/S2772572325001013AusculationPortal hypertensionCirrhosisLiver transplant
spellingShingle Maria Mironova
Nadera Altork
Harish Gopalakrishna
David E. Kleiner
Theo Heller
Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
Gastro Hep Advances
Ausculation
Portal hypertension
Cirrhosis
Liver transplant
title Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
title_full Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
title_fullStr Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
title_full_unstemmed Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
title_short Listen to Patient’s Gut: A Case Report of a Woman With Fatigue and Bruising
title_sort listen to patient s gut a case report of a woman with fatigue and bruising
topic Ausculation
Portal hypertension
Cirrhosis
Liver transplant
url http://www.sciencedirect.com/science/article/pii/S2772572325001013
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