PMC4671547_01
Endoscopic images. (A) No blood was retained in the duodenal bulb; however, a small volume of fresh blood was observed in the inferior duodenal angulus. (B) After the scope was replaced with Olympus PCF-PQ260L, continuously gushing blood was observed from a diverticulum in the horizontal portion of the duodenum. (C and D) Subsequently, hemostasis was performed by argon plasma coagulation after the lesion was anteriorly viewed through a transparent tip hood.
cgast-8-2015-061f1.jpg
PMC4671547_01_cgast-8-2015-061f1.jpg
f1-cgast-8-2015-061
While the bleeding point was anteriorly viewed by pressing the mucosa with the transparent tip hood, hemostasis was performed successfully (Fig. 1).
Contrast-enhanced abdominal CT images taken after hemostasis. A clip for marking persisted. There was no free air or other changes around the diverticulum.
cgast-8-2015-061f2.jpg
PMC4671547_01_cgast-8-2015-061f2.jpg
f2-cgast-8-2015-061
Contrast-enhanced abdominal computed tomography (CT) by argon plasma coagulation performed after the treatment showed that there was no free air or other changes around the diverticulum (Fig. 2).
Hypotonic duodenal images. A solitary diverticulum measuring 15 mm was detected at the cranial part of the horizontal portion of the duodenum.
cgast-8-2015-061f3.jpg
PMC4671547_01_cgast-8-2015-061f3.jpg
f3-cgast-8-2015-061
Hypotonic duodenal imaging revealed that the diverticulum was solitary, extraluminally protruding from the cranial part of the central horizontal portion of the duodenum by 15 mm (Fig. 3).