Haemorrhage from the left gastroepiploic artery: beware of the acute abdomen post endoscopic ultrasound biliary drainage

Abstract

described with acute haemorrhage into pulmonary and hepatic lesions, both primarily and following chemotherapy initiation. 3,4 Gastrointestinal haemorrhage has been described from gastric, jejunal and colonic metastases. 9,10 These patients have very high-risk disease and should be treated in a high-volume, tertiary centre. 3 In conclusion, this case represents an unusual presentation of metastatic, testicular choriocarcinoma initially presenting with clinical suspicion of epididymo-orchitis and subsequently metastatic rectal cancer. Clinicians must consider testicular malignancy in any case of non-healing wound or complicated scrotal masses, even in the absence of discrete testicular lesions. Serum tumour markers and histopathological examination should be performed. Choriocarcinoma is an aggressive, rapidly progressive malignancy and, although it is rare, metastasis to the gastrointestinal tract needs to be borne in mind.