Case Report
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2011; 17(35): 4048-4051
Published online Sep 21, 2011. doi: 10.3748/wjg.v17.i35.4048
Esophageal mucosal lesion with low-dose aspirin and prasugrel mimics malignancy: A case report
Gui-Fen Ma, Hong Gao, Shi-Yao Chen
Gui-Fen Ma, Hong Gao, Shi-Yao Chen, Department of Gastroenterology, Zhongshan Hospital Fudan University, Shanghai 200032, China
Author contributions: Ma GF collected the data and wrote the manuscript; Gao H was responsible for the patient care and revised the manuscript; Chen SY designed and organized the research and performed endoscopy.
Correspondence to: Shi-Yao Chen, MD, Professor, Department of Gastroenterology, Zhongshan Hospital Fudan University, Shanghai 200032, China.
Telephone: +86-21-64041990 Fax: +86-21-64432583
Received: January 26, 2011
Revised: May 19, 2011
Accepted: May 26, 2011
Published online: September 21, 2011

Dual antiplatelet therapy consisting of low-dose aspirin (LDA) and other antiplatelet medications is recommended in patients with coronary heart disease, but it may increase the risk of esophageal lesion and bleeding. We describe a case of esophageal mucosal lesion that was difficult to distinguish from malignancy in a patient with a history of ingesting LDA and prasugrel after implantation of a drug-eluting stent. Multiple auxiliary examinations were performed to make a definite diagnosis. The patient recovered completely after concomitant acid-suppressive therapy. Based on these findings, we strongly argue for the evaluation of the risk of gastrointestinal mucosal injury and hemorrhage if LDA therapy is required, and we stress the paramount importance of using drug combinations in individual patients.

Keywords: Esophageal injury, Low-dose aspirin, Prasugrel, Gastrointestinal hemorrhage, Drug-eluting stent