Acute bleed from gastric fundus biopsy site
Acute melena and tachycardia. Endoscopy normal.
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Technique: non contrast, arterial and 30 sec delayed phases. IV contrast administered from the right leg.
Large heterogenous density haematoma within the lumen of the dilated stomach. This is secondary to an acute arterial haemorrhage at the gastric fundus, seen on the arterial phase and pooling on the delayed phase. No other point of haemorrhage identified.
Incidental calcified gallstones, no gallbladder wall thickening. The remaining intra-abdominal contents are unremarkable.
Dependent consolidation in the lung bases represents atelectasis or aspiration. Small bilateral pleural effusions.
Arterial haemorrhage arising in the wall of the gastric fundus. This is at the site of recent endoscopic biopsy.
The patient returned to the gastro department for endoscopy and the bleeding vessel was cauterised.