Gastric Dieulafoy's lesion

Active bleeding from a gastric Dieulafoy's lesion (A) along the proximal antrum/anterior wall. The bleeding was controlled with combination endoscopic therapy consisting of: Injection therapy with a 10 French Injector-Gold Probe (Microvasive Corp) using 1:10,000 epinephrine (B), followed by bipolar electrocoagulation at 12 Watts x 10 sec/pulse x 4 pulses using firm tamponade pressure (C), then hemoclipping x 1 (Olympus Corp) (D). India ink tatooing (E) was then performed to mark the treatment site in the event of rebleeding and facilitate localization if surgical intervention (such as wedge resection) is required.