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Art in Endoscopy: Moai Monolith Mysteries
A patient with significant aortic valve stenosis underwent esophagogastroduodenoscopy (EGD) with routine biopsies. Subsequently there was a decrease in hemoglobin, and repeat EGD exposed this fascinating image resembling an Easter Island Moai statue. The true meaning and appearance of these statues is still heavily debated by archeologists worldwide. Just like the monoliths, the exact origin of the ulcer proved mysterious. An enthusiastic biopsy possibly coupled with a mechanism similar to Heyde’s syndrome evoked this elegant yet enigmatic clot. In Heyde’s syndrome, the combination of shear stress and cleavage by the ADAMTS13 enzyme makes von Willebrand factor hemostatically less competent. Hemostasis of this oozing ulcer was obtained after bipolar electrocoagulation.
Gertjan Rasschaert, MDDepartment of Gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
22 September 2021 (online)
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