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A 74-year-old Turkish woman was admitted with loss of appetite, weight loss and progressive anaemia. Her medical history included rheumatoid arthritis, type 2 diabetes and end-stage renal disease with nephrotic syndrome diagnosed 2 years ago. Endoscopy of the upper GI tract revealed a distinct intramural gastric haematoma with diffuse, seeping haemorrhage and large gastric intraluminal blood clots (figure 1A, B; online supplementary films 1 and 2). The mucosa appeared partly necrotic, and the gastric wall showed a sponge-like consistence and marked vulnerability. An abdominal CT scan was performed.
Contributors RJvE, BS and AK wrote the manuscript and prepared figures. RJvE and AK collected patient data and examination results. AM and AK did the endoscopy images. SAS prepared the X-ray studies. TS and AK supervised the study.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.