Ménétrier’s disease manifesting as upper gastrointestinal bleeding: An exceedingly rare case report

Ménétrier’s disease (MD) is a rare condition characterized by prominently enlarged gastric folds at the level of the gastric body and fundus. The gastric antrum is usually spared. MD can present with a variety of symptoms: non-specific abdominal pain, nausea, vomiting, and peripheral edema. However, a localized MD manifesting as melena is an exceedingly rare condition. A 51-year-old male patient sought medical care with a complaint of melena and a hemoglobin level of 7.0 g/dL. An esophagogastroduodenoscopy (EGD) was performed and revealed hypertrophic gastric folds at the level of the body and fundus. Biopsies revealed foveolar hyperplasia with corkscrewing and elongation of crypts, corroborating a diagnosis of MD. Patient was prescribed proton pump inhibitors (PPIs) and was scheduled for a follow-up with the gastroenterologist. An annual upper endoscopy was recommended due to the increased risk of gastric cancer. While MD is a rare entity, the combination of MD and melena is exceedingly rare and atypical. This article highlights the fact that physicians should keep the diagnosis of MD in their differentials when dealing with a patient presenting with an upper gastrointestinal (GI) bleed and enlarged gastric mucosal folds on upper endoscopy. • Upper gastrointestinal hemorrhage can be the presenting symptom of Ménétrier’s disease. • Physicians should have a high index of suspicion to diagnose MD in the setting of upper GI hemorrhage and enlarged gastric mucosal folds on endoscopy. • Upper GI bleed in MD should be promptly recognized and treated.