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.
