{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:54:59Z","timestamp":1760057699903,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Upper gastrointestinal (GI) bleeding is a common emergency, typically requiring prompt intervention. This case report presents a unique situation where apparent GI bleeding was ultimately identified as anaphylaxis triggered by accidental wasp ingestion. Such cases are rare, underscoring the need for a broad differential diagnosis in atypical presentations. Case Presentation: A 53-year-old male with a history of heavy alcohol use presented with presumed acute hematemesis, hypotension, and tachycardia. An initial examination revealed mild anemia and elevated liver enzymes. An urgent upper GI endoscopy showed severe esophagitis with no signs of active or stigmata of recent bleeding; instead, two dead wasps were found in the gastric antrum. Further inquiry revealed that the patient had recently consumed a home-brewed alcoholic beverage, likely contaminated with the wasps. The patient\u2019s symptoms were then attributed to anaphylaxis from venom exposure rather than hemorrhagic shock. The patient\u2019s condition improved with antihistaminic therapy, and he was discharged with follow-up recommendations. Conclusions: This case highlights the importance of considering rare but critical diagnoses, such as insect-induced anaphylaxis, in patients presenting with presumed GI bleeding. It reinforces the value of thorough history taking, prompt endoscopy, and systematic management in assessing and treating atypical emergency presentations.<\/jats:p>","DOI":"10.3390\/reports8010026","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T05:34:26Z","timestamp":1739943266000},"page":"26","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Signs of an Unexpected Guest in a Case of Apparent Upper Gastrointestinal Bleeding Leading to an Endoscopic Extraction of a Foreign Body: A Case Report"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-8630","authenticated-orcid":false,"given":"Rare\u0219","family":"Cr\u0103ciun","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Department of Gastroenterology, \u201cProf. Dr. Octavian Fodor\u201d Institute of Gastroenterology and Hepatology, 19-21 Croitorilor Street, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Tefas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Department of Gastroenterology, \u201cProf. Dr. Octavian Fodor\u201d Institute of Gastroenterology and Hepatology, 19-21 Croitorilor Street, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1055\/a-1369-5274","article-title":"Endoscopic Diagnosis and Management of Nonvariceal Upper Gastrointestinal Hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline\u2014Update 2021","volume":"53","author":"Gralnek","year":"2021","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E990","DOI":"10.1055\/a-1187-1154","article-title":"Endoscopic Treatment of Variceal Upper Gastrointestinal Bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Cascade Guideline","volume":"8","author":"Karstensen","year":"2020","journal-title":"Endosc. Int. Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/all.15032","article-title":"EAACI Guidelines: Anaphylaxis (2021 Update)","volume":"77","author":"Muraro","year":"2022","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"407","DOI":"10.5414\/ALX02543E","article-title":"Occupational Anaphylaxis: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI)","volume":"8","author":"Treudler","year":"2024","journal-title":"Allergol. Select"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/ACI.0000000000000066","article-title":"Anaphylaxis as Occupational Risk","volume":"14","author":"Moscato","year":"2014","journal-title":"Curr. Opin. Allergy Clin. 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Med."},{"key":"ref_9","first-page":"S24","article-title":"Unusual Summertime Foreign Body in the Esophagus","volume":"31","author":"Kesseler","year":"1999","journal-title":"Endoscopy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"E185","DOI":"10.1055\/s-0034-1391834","article-title":"A Stinging Wasp in the Stomach: Accidental Endoscopic Diagnosis of a Systemic Anaphylactic Reaction","volume":"47","author":"Geraci","year":"2015","journal-title":"Endoscopy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/all.13262","article-title":"EAACI Guidelines on Allergen Immunotherapy: Hymenoptera Venom Allergy","volume":"73","author":"Sturm","year":"2018","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1055\/a-2205-2613","article-title":"Training in Basic Gastrointestinal Endoscopic Procedures: A European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopic Nurses and Associates (ESGENA) Position Statement","volume":"56","author":"Antonelli","year":"2024","journal-title":"Endoscopy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1055\/s-0042-100456","article-title":"Removal of Foreign Bodies in the Upper Gastrointestinal Tract in Adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"48","author":"Birk","year":"2016","journal-title":"Endoscopy"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/1\/26\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:37:48Z","timestamp":1760027868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/1\/26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["reports8010026"],"URL":"https:\/\/doi.org\/10.3390\/reports8010026","relation":{},"ISSN":["2571-841X"],"issn-type":[{"type":"electronic","value":"2571-841X"}],"subject":[],"published":{"date-parts":[[2025,2,19]]}}}