Presentation
Acute melena and tachycardia. Endoscopy normal.
Patient Data
Technique: non contrast, arterial and 30 sec delayed phases. IV contrast administered from the right leg.
Large heterogenous density hematoma within the lumen of the dilated stomach. This is secondary to an acute arterial hemorrhage at the gastric fundus, seen on the arterial phase and pooling on the delayed phase. No other point of hemorrhage 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 hemorrhage 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.