PMC149361_01
DL of the duodenum. Note the deformed duodenal bulb with small clot adherent to the mucosa in the postbulbar area. The mucosa is normal and there is no evidence of any duodenal ulcer. Lesion was missed on (first) endoscopy because it was covered with the tiny clot and the surrounding mucosa was normal.
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PMC149361_01_1471-230X-3-2-1.jpg
F1
Few clots were seen adherent to the postbulbar mucosa that appeared grossly normal (Figure 1).
DL of the duodenum. An actively bleeding DL in the postbulbar duodenum (same case shown in Figure 1). Repeat endoscopy, 24 hours later, immediately following rebleeding showed actively bleeding vessel in postbulbar duodenum. The surrounding mucosa is edematous because of adrenaline injection.
1471-230X-3-2-2.jpg
PMC149361_01_1471-230X-3-2-2.jpg
F2
The surrounding mucosa was normal (Figure 2).
PMC149361_02