{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:03Z","timestamp":1756325403846,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,30]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>A 92-year-old man hospitalised for cerebral infarction developed haematemesis. The patient was taking low-dose aspirin and apixaban for his cerebral infarction and non-valvular atrial fibrillation. His enteral nutrition was administrated through nasogastric tube. Upper endoscopy revealed active bleeding from a protruded lesion in the upper oesophagus. The lesion was removed by washing with a water jet, followed by successful endoscopic haemostasis. Histopathological examination revealed degenerated squamous epithelium without specific findings; the diagnosis was exfoliative oesophagitis. In our case, mechanical mucosal injury caused by nasogastric tube placement may result in exfoliative oesophagitis. In addition, the use of low-dose aspirin with apixaban may have contributed to the bleeding. We then performed a wire-guided nasogastric tube placement under fluoroscopy. No further bleeding was observed, but the patient died of sepsis 1\u2009month later. This case highlights the importance of a risk assessment and management of oesophageal complications associated with nasogastric tube placement.<\/jats:p>","DOI":"10.1136\/bcr-2020-237485","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T16:19:59Z","timestamp":1606148399000},"page":"e237485","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Haemorrhagic exfoliative oesophagitis associated with nasogastric tube placement"],"prefix":"10.1136","volume":"13","author":[{"given":"Gota","family":"Sudo","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan"},{"name":"Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 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