Images of the month 2: A rare case of haematemesis from a gastric submucosal lesion

摘要

appetite. Following fluid resuscitation, an upper gastrointestinalendoscopy was performed. A large submucosal lesion withulceration and oozing blood was observed in the gastric fundus(Fig 1 ). Endoscopic haemostasis was achieved through injectionof adrenaline and application of Haemospray TM but clips weredifficult to place given the size of the ulcer. An initial provisionaldiagnosis of a gastrointestinal stromal tumour (GIST) was madegiven the submucosal lesion and bleeding nature of the mass.However, computed tomography (CT) showed a fungating massarising from the fundus of the stomach, which was of fat density(Fig 2 ). The patient was conservatively treated, edoxaban wasstopped and no further interventions were planned. He had norecurrence of bleeding and was discharged safely.