Bleeding Duodenal Ulcer

LEFT: Active oozing of blood from the upper edge of a fibrin-based ulcer in the duodenal bulb of a 69 year-old man.

CENTER: Rounded protuberance represents a visible vessel responsible for bleeding from a duodenal ulcer in this 69 year-old woman with hematemesis (vomiting blood). Vessel shown here between spurts of bleeding.

RIGHT: 48 year-old woman with hematemesis and melena. Endoscopy revealed a sentinel clot attached to an underlying ulcer in the duodenal bulb, with active bleeding. The lesion was successfully cauterized with a bipolar gold probe, achieving hemostatic control.

75 year-old man with hematemesis and melena. Endoscopy revealed a "sentinel clot" attached to a cresenteric ulcer in the duodenum (LEFT). Lavage dislodged the clot, revealing the underlying raised "visible vessel" (CENTER). The vessel was successfully eradicated via cautery with the bipolar gold probe (RIGHT).