DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.001

Pages: 2112-2117

Hematidrosis, also reported as hematohidrosis, is an exceedingly rare condition in which blood or blood-stained fluid is discharged through intact skin, most often from the face, the scalp or the flexural folds, and usually in relation to intense emotional stress. Fewer than one hundred well-documented observations have been published, and involvement of mucosal surfaces bloody tears, blood-stained ear discharge, epistaxis or bleeding from the oral cavity is described in a minority of them. Digestive presentations are exceptional and, when they occur, they raise the difficult question of whether the blood arises from a true gastrointestinal lesion or from the disease itself. We report the case of a 21-year-old woman with hematidrosis diagnosed at the age of twelve, at that time after recurrent epistaxis, whose diagnosis had been established at the age of twelve after recurrent epistaxis and blood-stained saliva, and who presented to the emergency department with repeated episodes of low-volume haematemesis. She was conscious and well oriented and remained haemodynamically stable, with a systolic blood pressure of 130 mmHg and a mean arterial pressure of 70 mmHg, but with sinus tachycardia at 120 beats per minute; the respira-tory rate was 14 breaths per minute, peripheral oxygen saturation was 99% on room air and the abdomen was soft and non-tender. A cutaneous bleeding episode was witnessed during the stay in the emergency department. The full blood count showed no anaemia and a normal platelet count, the prothrombin time and the international normalised ratio were normal, and the D-dimer concentration was moderately raised. She received peripheral venous access, high-dose intravenous proton pump inhibitor therapy, tranexamic acid 1 g by slow intravenous infusion and intravenous fluids, and was kept fasting pending endoscopy. Upper gastrointestinal endoscopy demonstrated erythematous gastritis, with no ulcer, no varices and no identifiable source of bleeding. The p