Mid-gut bleeding due to a chronic splanchnic vascular stricture with secondary portal hypertension after gastric bypass

A 41-year-old man presented with a 24-hour history of melena and exacerbated epigastric pain 6 years after undergoing a laparoscopic Roux-en-Y gastric bypass for morbid obesity. He had been experiencing recurrent abdominal pain and episodes of melena in the preceding months. His past medical history also included protein C deficiency and a pulmonary embolism treated with anticoagulant therapy, which had been stopped 6 months earlier following...