PMC8592922_01
(A) Imaging is performed via the hepatic artery with the REBOA balloon inflated. A large volume of extravasation from the gastroduodenal artery is seen in the duodenum. (B) After completion of the embolization procedure, imaging is performed via the celiac artery with the REBOA balloon deflated. The gastroduodenal artery has been embolized with coils, and the extravasation has almost completely disappeared. (C) After completion of the embolization procedure, imaging is performed via the superior mesenteric artery with the REBOA balloon deflated. The ischemic area associated with embolization was small, and there were no significant complications.
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F1
Duodenal hemorrhage was suspected based on the patient's clinical course, and upper gastrointestinal endoscopy was scheduled the following day due to gastric fullness (Supplementary Figure 1). Imaging was performed via the celiac and superior mesenteric arteries, and extravasation was seen from the gastroduodenal artery to within the duodenum (Figure 1A). Angiography performed after embolization showed that the extravasation had nearly disappeared (Figure 1B). The ischemic area associated with embolization was confirmed to be small (Figure 1C), and there were no significant complications.
Upper gastrointestinal endoscopy imaging findings. Visible are the ulcer and leakage of the coils used to perform embolization in the anterior wall of the duodenal bulb.
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F2
Upper gastrointestinal endoscopy performed on day 11 of hospitalization showed an ulcer in the anterior wall of the duodenal bulb and coil extrusion but no bleeding (Figure 2).