ABSTRACT Obscure gastrointestinal bleeding is recurrent or persistent bleeding after negative esophagogastroduodenoscopy and colonoscopy. We report an 81-year-old man with hematochezia and acute anemia after nondiagnostic esophagogastroduodenoscopy/colonoscopy and tagged red blood cell scan. Enteroscopy revealed gastric bleeding with folds suspicious for gastric varices. Endoscopic ultrasound demonstrated prominent submucosal vessels and a ∼3 cm perigastric cystic lesion near the pancreas. Portal venous-phase computed tomography identified a pseudoaneurysm along the lesser curvature arising from a left gastric artery branch. Catheter angiography confirmed the lesion and coil embolization achieved durable hemostasis.
Onwuzo et al. (Wed,) studied this question.