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.