Background Upper gastrointestinal bleeding with complicated factors is always difficult to find the primary origin. Case presentation Here we present a case of a 74-year-old male farmer suffered from acute upper gastrointestinal bleeding caused by gastric ulcer and Mallory-Weiss syndrome and chronic anemia which was at last found caused by hook worm infection. Conclusion It tells us that considering multi-possibility when can not explain the symptom with monophyletism is very important for clinicians.
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