case_images: PMC11268008_01
case_images: Mucosal protuberance with potential submucosal artery.
case_images: 10.1177_23247096241263062-fig1.jpg
case_images: PMC11268008_01_10.1177_23247096241263062-fig1.jpg
case_images: fig1-23247096241263062
case_images: Upper endoscopy demonstrated large clots in the gastric fundus which upon suctioning revealed a mucosal protuberance with the suggestion of a potential submucosal "caliber-persistent" artery that protrudes through the mucosa at the gastric fundus without primary or surrounding mucosal ulceration (Figure 1).
case_images: Likely Dieulafoy's lesion at previously noted protuberance, with no signs of active GIB.
case_images: 10.1177_23247096241263062-fig2.jpg
case_images: PMC11268008_01_10.1177_23247096241263062-fig2.jpg
case_images: fig2-23247096241263062
case_images: After confirming the absence of an underlying gastric fundal varix, a second endoscopy was performed when the patient had a further drop in Hb without overt melena, which reaffirmed the presence of a DL at the previously noted protuberance (Figure 2).
case_images: Lesion with hemostatic clips in place.
case_images: 10.1177_23247096241263062-fig3.jpg
case_images: PMC11268008_01_10.1177_23247096241263062-fig3.jpg
case_images: fig3-23247096241263062
case_images: As no other lesions that could explain the source of melena were noted, 3 hemostatic clips were placed over this lesion (Figure 3).
case_images: Lesion with OTSC-P in place.
case_images: 10.1177_23247096241263062-fig4.jpg
case_images: PMC11268008_01_10.1177_23247096241263062-fig4.jpg
case_images: fig4-23247096241263062
case_images: After adequate resuscitation, we performed another endoscopy where the previously placed hemostatic clips were removed with rat tooth forceps, and an OTSC-P (Figure 4) was deployed at the site.