Watermelon stomach is an increasingly recognizable cause of persistent acute or occult gastrointestinal bleeding, especially in elderly women. The chief presentation is severe iron deficiency anemia and occult or overt gastrointestinal bleeding. Diagnosis is made on endoscopy by the characteristic appearance of visible watermelon linear stripes in the antrum. Histology is rarely needed to confirm the diagnosis. The importance of this lesion lies in the proper recognition since it is amenable to successful therapeutic interventions, leading to endoscopic healing of the lesion, significant improvement in the anemia and a reduction in the need for blood transfusions.
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