fig3

Figure 3. Late postoperative hemorrhage after primary RYGB. The patient presented with hematemesis, epigastric abdominal pain, nausea/ vomiting, and anemia 4 years after a primary RYGB procedure. EGD was performed, and ulceration at GJA was detected with recent but not active bleeding signs. The ulcer bed was covered by fibrin, which was left in place. Definitive treatment was achieved with GJA revision due to recurrent bleeding. RYGB: Roux-en-Y gastric bypass; EGD: esophagogastroduodenoscopy; GJA: gastrojejunal anastomosis.