title: Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report.
abstract: BACKGROUND
  In this paper we are reporting one case of exsanguinating upper gastrointestinal tract (GIT) bleed requiring massive blood transfusion and immediate life saving surgery.
  
  
  METHODS
  A 30 years old female, 12 weeks pregnant was referred to our hospital from the earth-quake affected area of Kashmir with history of upper abdominal pain, haematemesis and melaena for one week. After stabilizing the patient, upper gastro-intestinal endoscopy was performed. It revealed gastric ulcer just distal to the gastro-esophageal junction on the lesser curvature. Biopsy from the ulcer edge led to profuse spurting of the blood and patient went into state of shock. Immediate resuscitation led to rebleeding and recurrence of post haemorrahagic shock.
  
  
  CONCLUSIONS
  The patient was immediately explored and total gastrectectomy with splenectomy concluded as life saving procedure. A review of literature was conducted to make this report possible.
authors.affiliation: Department of surgery, Islamic International Medical College, Rawalpindi, Pakistan. mikhandr@gmail.com.
authors.forename: Mohammad Iqbal
authors.initials: MI
authors.lastname: Khan
authors.forename: Muhammad Tariq
authors.initials: MT
authors.lastname: Baqai
authors.forename: Mohammad Fahd
authors.initials: MF
authors.lastname: Baqai
authors.forename: Naveed
authors.initials: N
authors.lastname: Mufti