A 32 year-old man presented with melena and severe anemia, resulting in syncope. Left: Endoscopy revealed an ulcer with a large adherent clot in the duodenal bulb.

Center: After the clot was suctioned away, a small ulcer with visible vessel became evident.

Right: Large sentinel clot in a duodenal ulcer found in an 82 year-old woman who presented with hematemsis.