Case
A 41-year-old Tunisian male diagnosed with an acute lymphoblastic leukemia was admitted to our hospital for a chemotherapy cure (Hyper-CVAD: Cyclophosphamide, Vincristine Sulfate, Doxorubicin Hydrochloride and Dexamethasone). During the hospitalization, he presented an acute epigastric pain with hemodynamic instablility and fever. Physical examination revealed abdominal tenderness. The thoroco-abdominal CT scan showed circumferential gastric thickening with an enhancement defect suggestive of gastric ischemia associated with segmental pulmonary embolism (Figure 1). He was treated with noradrenaline, intravenous fluids, intravenous proton pump inhibitors, broad-spectrum antibiotics and anticoagulants with favorable clinical outcome. At day 7, he underwent an upper endoscopy. It revealed hypertophic, ulcerated fundic folds covered with false membranes with necrotic foci, extending from the proximal body to the proximal antrum (Figure 2). Histology was compatible to the endoscopic suspicion of gastric ischemia. The patient was discharged after 2 weeks of medical treatment and was reevaluated at 1 month, remaining asymptomatic.