2025 Volume 67 Issue 4 Pages 300-304
A 76-year-old man presented with hematemesis. Emergency endoscopy revealed a gently sloping submucosal bump on the anterior wall of the duodenal bulb with active bleeding from the apex, which was managed with local injection of epinephrine for hemostasis. Further investigation identified a pseudoaneurysm of the gallbladder artery as the source of biliary hemorrhage, which was successfully treated with vascular embolization. The duodenal hemorrhage was attributed to a perforation caused by the pseudoaneurysm. A biopsy of the duodenal lesion revealed gallbladder cancer, and the pseudoaneurysm was deemed a complication of the cancer. Although duodenal perforation from a pseudoaneurysm of the gallbladder artery due to gallbladder cancer is extremely rare, this condition should be considered in the differential diagnosis of bleeding duodenal ulcers in the duodenal bulb.
