PMC10318342_01
CT-scan of the abdomen showing (A) the presence of blood in the stomach, aerobilia (yellow arrow) and (B) inflammation of the first part of duodenum (red arrow).
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F1
This revealed a CDF, inflammation of the first part of duodenum, signs of cholangitis and the presence of blood in the stomach (Figure 1).
Endoscopic picture showing the 1A Forrest duodenal ulcer with the presence of a choledocho-duodenal fistula (CDF) and an active bleeding of the gastro-duodenal artery around the fistula (B).
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F2
An urgent esophagogastroduodenoscopy was performed, which showed a Forrest 1A posterior duodenal ulcer with an active bleeding of the gastro-duodenal artery, as well as the presence of air and bile, which was controlled with an Over The Scope Clip (Figures 2, 3).
Endoscopic picture showing the 1A forrest duodenal ulcer treated with an over the scope clip.
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F3
An urgent esophagogastroduodenoscopy was performed, which showed a Forrest 1A posterior duodenal ulcer with an active bleeding of the gastro-duodenal artery, as well as the presence of air and bile, which was controlled with an Over The Scope Clip (Figures 2, 3).