Identifying the cause of this patient’s gastrointestinal distress was like getting blood out of a stone.

The 23-year-old Brazilian presented with a six-day history of melaena with one recent instance of massive haematochezia.

On examination, she was hypotensive (90/46mmHg), tachycardic (116bpm) and had a haemoglobin of 6.7g/dL. She had no comorbidities or relevant medication.

She was intubated and received volume replacement of fluids and packed red blood cells.