49 year-old man, with a history of subtotal gastrectomy for bleeding peptic ulcer 10 years previously, presented with melena and anemia. At endoscopy, an acutely bleeding ulcer was found on the jejunal side of the anastomosis. The photograph shows a jet of blood pulsating upward, with blood obscuring the ulcer itself. This arterial bleeding did not respond to endoscopic measures, and required surgical intervention.