Acute bleed from gastric fundus biopsy site

Case contributed by Dr Craig Hacking

Presentation

Acute melena and tachycardia. Endoscopy normal.

Patient Data

Age: 68
Gender: Female

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.

IDC noted.

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.

Conclusion

Arterial haemorrhage arising in the wall of the gastric fundus. This is at the site of recent endoscopic biopsy.

Case Discussion

The patient returned to the gastro department for endoscopy and the bleeding vessel was cauterised.

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Case information

rID: 35201
Case created: 26th Mar 2015
Last edited: 11th Aug 2017
Tag: biopsy
Inclusion in quiz mode: Included

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