Endoscopic Management of Acute Gastrointestinal Bleeding From a Gastric Lipoma: A Case Report, Literature Review, and Treatment Recommendation With Reference to ESGE Guidelines.

Background: Acute gastrointestinal bleeding from a gastric lipoma is a very rare but severe condition, about 50 cases of which have been reported in the worldwide literature at the time of writing. It largely occurs from a lesion larger than 4 cm localized in the antrum of the stomach. Objective: We report the case of a patient with severe comorbidities presenting with melena and, on examination, a large subepithelial lesion in the gastric antrum, with a small ulceration and visible vessel at the summit. After stabilization and endoscopic hemostasis, the lesion was successfully treated by endoscopic submucosal dissection and a diagnosis of a large gastric antral lipoma was confirmed. We have collected similar case reports published worldwide and made a careful review of the literature and ESGE guidelines; we present these here with the aim of helping to find the best modality of treatment for future patients with large gastric lipoma. Conclusion: We present, to the best of our knowledge, the first case of acute gastrointestinal bleeding from a gastric lipoma in the Czech Republic, discuss the existing literature on similar cases, and make recommendations for the treatment of this condition in line with the relevant ESGE guidelines.