Upper GI bleeding - duodenal ulcer

Case contributed by Andrea Molinari
Diagnosis certain

Presentation

Massive hematemesis

Patient Data

Age: 70 years
Gender: Female
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ early
arterial phase
This study is a stack
Axial C+ late
arterial phase
This study is a stack
Axial C+ portal
venous phase
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Info

Dilation of the stomach with endoluminal antral and post-piloric active bleeding, increasing in the dynamic contrastographic phases.

It was presumed that the origin of the bleeding was from the gastroduodenal artery or its branches.

Case Discussion

The patient underwent surgical ligation of the gastroduodenal artery, a branch arising from the hepatic artery of the celiac trunk, supplying the pylorus and proximal duodenum.

Duodenal ulcers are at high risk because the gastroduodenal artery is located just behind the posterior wall of the duodenum, and its erosion may lead to massive bleeding 1.

Acknowledgements: Cancelli C, MD, Consultant radiologist

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