Duodenal ulcer bleeding

Case contributed by Domenico Nicoletti
Diagnosis certain


Anemia, melena and hematemesis in a patient on antiplatelet therapy (Hb 6.2g/dl, HCT 24%).

Patient Data

Age: 65 years
Gender: Male

In the duodenal bulb, at the passage into the second portion of the duodenum, at the level of the upper wall, an active bleeding is visible in the arterial phase, which by gravity collects inferiorly in the duodenum.





Large and superficial ulcerations of the duodenal bulb with visible vessel treated by mechanical hemostasis with three endoclips.

Case Discussion

Upper digestive tract hemorrhage manifests itself with melena and hematemesis. The symptoms that precede these signs are asthenia, sweating, pallor and gastric disorders. 

There are many causes that can lead to digestive hemorrhage. Among these, peptic ulcer and duodenal ulcer are the main ones.

A previous history of dyspepsia, ulcers and bleeding, along with the use of non-steroidal anti-inflammatory drugs and antiplatelet agents, are risk factors most often present in patients with superior digestive tract bleeding.

Thank you, Dr. Sandra Pennacchini

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