An unusual cause of GI bleeding

Clinical presentation A 62-year-old woman with a history of hypertension and diabetes mellitus presented with 3 days intermittent passage of melena. Physical examination was unremarkable. The pertinent laboratory findings were haemoglobin, 10.3 g/dL (normal range, 12.0–16.0 g/dL); platelet count, 136x103/μL (normal range, 150–400x103/μL); prothrombin time, 11.9 s (control, 10.6 s; international normalised ratio, 0.91); and activated partial thrombin time, 28.1 s (control, 31.3 s). Esophagogastroduodenoscopy (EGD) revealed a 3 cm tumour with a central ulceration and adherent blood clot protruding into the gastric antrum (figure 1A); biopsy revealed chronic gastritis. She was treated with proton-pump inhibitors, and EGD performed 1 month later revealed slight improvement of the lesion (figure 1B). EGD performed 6 months later showed enlargement of the tumour with a central ulceration (figure 1C). A biopsy again revealed only chronic gastritis. A CT scan revealed focal wall thickening of the antrum and no tumour was found in other parts...

Source: Gut - June 2, 2016 Category: Gastroenterology Authors: Chen, T.-H., Chen, Y.-J., Tai, C.-M. Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research