Abstract
An 88-year-old woman with pernicious anemia and atrial fibrillation on apixaban was admitted for evaluation of refractory anemia. Characteristic findings on computed tomography and upper gastrointestinal endoscopy confirmed the diagnosis of gastric antral vascular ectasia. This case highlights the importance of endoscopic surveillance in refractory anemia, even when other causes of anemia are present, and emphasizes the need for clinicians to remain vigilant for easily overlooked signs on computed tomography.