A Case of Prolapsed Gastropathy Syndrome Presenting as Hematemesis and Acute Blood Loss Anemia

A 45-year-old male with hypertension and alcohol use disorder presented to the hospital after being found intoxicated, with bright red blood in the toilet and around his mouth. He was found to be tachycardiac and required intubation due to his inebriated state to establish a secure airway. Initial workup revealed a hemoglobin decrease from 16.7 g/dL to 8.7 g/dL, as well as lactic acidosis. He quickly underwent an upper endoscopy to evaluate his source of hematemesis. An actively bleeding lesion was found in the proximal stomach consistent with prolapse gastropathy syndrome. This case highlights a unique presentation of hematemesis that requires endoscopic evaluation for both diagnosis and treatment.