A 12-year-old boy with gastrointestinal bleeding.

A 12-year-old male patient presented to a local emergency department (ED) with approximately 12 hours of abdominal pain and multiple episodes of nausea and vomiting. When the emergency physician was eliciting the patient's medical history, the patient was discovered to have hemophilia A. His evaluation continued with a computed tomography (CT) scan of the abdomen and pelvis, which demonstrated several abnormalities, including a spontaneous transmural duodenal hematoma and retroperitoneal gastric obstruction.