Two Cases of Hemorrhagic Duodenal Ulcers Treated by Transcatheter Arterial Embolization

Abstract

Case 1 was an 80-year-old male who was brought to our institution by ambulance because of a hemorrhagic duodenal ulcer. Endoscopic treatment failed because of the poor field of vision. Computed tomography showed bleeding from the gastroduodenal artery, and an angiographic examination was performed. The bleeding was successfully controlled by transcatheter arterial embolization (TAE). Case 2 was a 57-year-old female. Although her hemorrhagic duodenal ulcer had been treated by endoscopic techniques three times, the bleeding recurred. During the fourth episode of bleeding, she lapsed into shock. Computed tomography showed the gastroduodenal artery located in the ulcer bed；TAE was performed, which successfully stopped the bleeding. Surgery or TAE should be performed in difficult cases with duodenal ulcers in order to ensure hemostasis. In some cases, TAE may be an easier, faster and safer method as compared to surgery. TAE is now considered the first-line therapy for massive UGI bleeding, and MDCT may help in the selection of the appropriate treatment method.