A duodenal lesion, which supposed that caused by an infection with hemorrhagic shock

Abstract

A case of a 35-year-old woman who was hospitalized at near clinic because of fervescence after abroad traveling. Laboratory data showed slight liver dysfunction and a high level of CRP. We suspected that she had a common cold and administrated her with antibiotics but no defervescence was observed. The results of tests denied the possibilities of collagen disease, meningitis, and imported infection. Abdominal CT showed mural tylosis of pars descendens duodeni, and the superior endoscopic image showed ulcers and multiple polyps dotted at pars descendens duodeni. She was moved to our hospital because of suspicion of duodenum Crohn's disease and aim of exact examination of fever unaccounted for. Five days after removal, sudden hematemesis induced Hb5.0 and hemorrhagic shock. We had to operate coil embolization in superior pancreaticoduodenal artery for hemostasis because she didn't response to blood transfusion. Multiple polyps dotted at duodenum tended to be cured but existed, but pathological observation suggested inflammatory reproductive polyp and denied Crohn's disease. We will report our experience of duodenal lesion unaccounted for with a discussion about the literatures.