A case of duodenal Dieulafoy-like lesion during warfarin potassium therapy successfully treated with endoscopic band ligation

Abstract

A 74-year-old female underwent operation of dissecting aortic aneurysm 8 years ago and had been administrated warfarin potassium ever since. She was admitted to our hospital because of epigastralgia. Endoscopic examination revealed a clot of blood in the stomach and Dieulafoy-like lesion at posterior wall of the duodenal bulb. We treated the lesion with endoscopic band ligation (EBL) using endoscopic variceal ligation (EVL) kit and could achieve hemostasis. In recent years, EBL has been used to treat not only esophageal varix but also non-variceal upper gastrointestinal hemorrhage. We report EBL using EVL kit is a safe and effective therapy for Dieulafoy-like lesion at duodenal bulb in patient with severe coagulopathy.