Figure 1. Top left: Index EGD showing a single cratered 8mm ulcer in the duodenal cap. Top right: Index EGD with active Dieulafoy bleed in the duodenal sweep, just distal to ulcer. Bottom left: 2nd EGD showing free floating suture material and ischemia in the fundus Bottom right: 2nd EGD showing obvious fistula with ischemic changes, obscured by clot and old blood during index endoscopy.
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