A 70 year old female was known to have a peptic ulcer for 14 years.10 years after her initial diagnosis she required blood transfusion for "melaena" (passage of grey-black, altered blood in the bowel motions), accompanied by fainting. Four years later, she complained of increasing abdominal pain, and was admitted to hospital with another episode of melaena. The bleeding was sufficiently masssive to cause hypovolaemic shock, and despite attempted resuscitation with large amounts of transfused blood, she died in the emergency department.