Upper gastrointestinal bleeding from duodenal vascular ectasia in a patient with cirrhosis

Figure 1 Endoscopy showing a vascular ectasia with active bleeding on the second portion of duodenum.

Figure 2 Biopsy from duodenal mucosa showing grossly dilated blood vessels (arrowheads) in the Brunner’s glands (HE, × 100).

Figure 3 Induction of hemostasis by APC (Arco-2000, Soring, Germany) (left) with blood oozing controlled without complications (right).

Figure 4 A one-week follow-up endoscopy showing the successfully controlled blood oozing from vascular ectasia on the second portion of the duodenum with APC (A) and a two-month follow-up endoscopy showing the ectatic vascular duodenal mucosa with no further spontaneous bleeding (B).