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A rare cause of GI bleeding in a 56-year-old man
  1. Pao-Ying Lin1,2,
  2. Jui-Hsiang Tang1,2,
  3. Chun-Chao Chang1,2
  1. 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  2. 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Chun-Chao Chang, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital and Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei 110, Taiwan; chunchao{at}tmu.edu.tw

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A 56-year-old man, with a known history of diabetes for 1 year, presented with a 5-day history of melena that was associated with one episode of haematemesis. One month prior, he had completed a course of oral amoxicillin for a dental infection that occurred after a tooth extraction. The only other significant past medical problem was hypertension for 10 years. Physical examination only showed pallor and abdominal examination was normal. Laboratory investigations revealed haemoglobin level of 8.4 g/dL and HbA1C of 7.8%. His upper GI endoscopy showed a diffuse irregular friable exudative ulcerative lesion involving the gastric fundus (figure 1). Endoscopic ultrasonography (EUS) demonstrated disrupted gastric wall layers with wall thickening of 5.1 mm and regional lymph nodes (figure …

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