Argon plasma coagulation is not effective in every vascular lesion

Patient B is a 98 year old male, referred for urgent outpatient upper gastrointestinal endoscopy because of a low haemoglobin of 6.0 gm/dL and current complaints of haemetemesis and malaena. He had received several transfusions of blood over the past few months. This patient has no history of any stigmata of liver disease. Argon Plasma Coagulation is the safe and accepted first line of treatment in some gastrointestinal vascular disorders like the ones found in Patient B. However this treatment was not only unhelpful in Patient A, but it increased the intensity of bleeding (figure 2).