Bacterial conjunctivitis

We recently diagnosed a case of multiple peptic ulcers. A 63 years-old man was transferred our hospital with melena and disturbance of consciousness. His-past medical history was unknown, but he had an appetite loss and 15 kg weight loss. He showed tachycardia and low blood pressure. On physical examination, he was emaciation and presented jaundice, abdominal extension, many scratch marks. Blood investigation showed anemia, liver failure, renal dysfunction, hypercoagulability, elevation of ammonia, and metabolic acidosis. A contrast enhanced computed tomography showed 3 cm sized several liver tumors, peripheral bile duct dilatation, and hepatic capsular depression in delayed enhancement, together with para-abdominal lymph node swelling and ascites. An esophagogastroduodenoscopy revealed multiple 0.51 cm sized A1 stage gastric and duodenal ulcers. We gave his family on diagnosis of end-stage cholangiocarcinoma, hepatic renal syndrome, hepatic encephalopathy due to decompensated cirrhosis, together with multiple peptic ulcers, and they offered palliative care. He died on 9th hospital day. In conclusion, to the best of our knowledge, there were no previous reports of such multiple peptic ulcers. The main reason for writing this report is the number of ulcers, which leads us to share our astonishment and experience with fellow readers.