Abstract
A 29-year-old female with a history of bipolar disorder presented to the emergency department (ED) with worsening epigastric pain. Two years ago, esophagogastroduodenoscopy (EGD) showed a 1.5-cm benign-appearing superficial ulcer in the pylorus. She was presumed to have an NSAID-induced peptic ulcer and was treated with proton pump inhibitor therapy. She had multiple hospitalizations for abdominal pain and several subsequent EGDs showing refractory gastric ulcer.
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