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Case 24: Epigastric discomfort and anaemia

An 82 year old lady was anaemic and had recent trouble with epigastric discomfort. She was worried if she would be fit enough for major surgery if something sinister was found in her stomach at endoscopy. This is a view of her duodenum.

1. Describe the appearance of the lesion

1. What would you do at endoscopy, and what further treatment would you advise?