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An unusual cause of GI bleeding
  1. Tzu-Haw Chen1,
  2. Yi-Ju Chen2,
  3. Chi-Ming Tai1
  1. 1Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
  2. 2Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
  1. Correspondence to Dr Chi-Ming Tai, Department of Internal Medicine, E-Da Hospital, 1, E-Da Rd, Jiau-Shu Village, Yan-Chau District, Kaohsiung 824, Taiwan, ROC; chimingtai{at}gmail.com

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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, 136×103/μL (normal range, 150–400×103/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 …

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