Abstract
A 56-year-old man presented to a local clinic complaining of malaise and loss of appetite. Laboratory data revealed a markedly low hemoglobin level (3.2g/dl), and he was referred to our hospital for further investigation. Upper gastrointestinal endoscopy revealed an ulcerative lesion in the duodenal bulb without active bleeding. Following emergency hospitalization, upper gastrointestinal endoscopy revealed hemorrhage from an ulcerative lesion in the superior duodenal angulus, and endoscopic repair was undertaken. Contrast enhanced CT showed a gastroduodenal artery aneurysm, and conservative treatment was commenced, but hemorrhage recurred. Transcatheter arterial embolization with metallic coils was performed, and the patient's clinical course was good. Endoscopic repair of a hemorrhaging gastroduodenal artery aneurysm can be difficult. Transcatheter arterial embolization should be considered when endoscopic repair is difficult in cases of hemorrhage from a gastroduodenal artery aneurysm.
