Endoscopic ultrasonography of an arteriovenous malformation in a gastric polyp.

A case of arteriovenous malformation in a gastric polyp in a 60-year-old male complicated by profuse bleeding after endoscopic polypectomy, and treated successfully by emergency surgery, is presented. The vascular abnormality was clearly visualized by endoscopic ultrasonography (EUS) prior to endoscopic removal of the polyp. Although endoscopic coagulation of the pedicle proceeded slowly and with the utmost care causing apparently adequate coagulation of the stalk, the depth, of coagulation appeared insufficient to prevent major haemorrhage. From this experience we would be inclined to recommend EUS examination of the pedicle of large polypoid lesions to document the size of the vascular structure before endoscopic transection is carried out.