Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
Case report
A case of massive bleeding from an ulcer in the posterior wall of the duodenum successfully treated with multimodal treatment
Koki KamiyamaTetsuji YamaguchiNatsuki KatoHideaki AnzaiTakahiko YanoKimiko KawaiKeiichi AraiAtsushi NakanoHideyuki Uotani
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2018 Volume 93 Issue 1 Pages 104-106

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Abstract

A 74-year-old male patient was admitted to our hospital with a diagnosis of ulcer in the upper gastrointestinal tract. Upper gastrointestinal endoscopy revealed a bleeding ulcer on the posterior wall of the duodenum, from which massive bleeding occurred during the examination. Because hemostasis could not be achieved by endoscopic procedures, we attempted an emergency transcatheter embolization. However, complete hemostasis could not be achieved, and the patient underwent emergency surgery. After laparotomy, the patient suffered cardiac arrest. We were able to achieve hemostasis by directly suturing the gastroduodenal artery which was exposed at the ulcer base, while resuscitating the patient by cardiac compression and massive blood transfusion. Wound closure was performed later in a two-step manner. He was discharged without delayed neurological complications on day 118 after the surgery.

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© 2018 Japan Gastroenterological Endoscopy Society Kanto Chapter
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