A Rare Case of Gastric Fundal Vascular Ectasia: A Unique Presentation and Diagnostic Challenge

A 75-year-old male patient was admitted with a two-week history of melena on a background of psoriatic arthritis and chronic iron-deficiency anaemia. Initial bloods confirmed acute-on-chronic anaemia with evidence of ongoing bleeding as the hemoglobin consistently dropped to 77g/L from 84g/L. After resuscitation which included giving a unit of blood transfusion, an urgent endoscopy revealed moderate gastric fundal vascular ectasia (GFVE) with active bleeding from three points and mild gastric antral vascular ectasia with no bleeding. Pulsed Argon-Plasma coagulation was successfully applied during endoscopy immediately, achieving haemostasis. Small Grade-2 oesophageal varices without bleeding were also noted. Subsequent imaging confirmed new liver cirrhosis with CHILD-PUGH scoring of 6 falling into category A, which was under investigation as outpatient. The patient's haemoglobin stabilized post-endotherapy with significant symptoms improvement and he was also given intravenous iron infusion. No further gastrointestinal bleeding event was noted until the writing of this article.