Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum

Keywords: Duodenal ulcer, X-ray endovascular interventions, arosive bleeding


The aim. To evaluate the effectiveness of X-ray interventions in arosive bleeding in patients with complicated duodenal ulcer.

Materials and methods. X-ray endovascular interventions were used in 8 patients who developed arosive bleeding as a complication of duodenal ulcer. All patients with signs of gastrointestinal bleeding were examined according to clinical protocols. Hemodynamically stable patients underwent X-ray endovascular interventions.

Results and discussion. In the near future, bleeding stopped in all 8 (100 %, OR–0.04 [0.005–0.29], p=0.03) patients. On day 2, two patients who underwent embolization of their own hepatic artery had a recurrence of bleeding (0.56 [0.065–4.76], p=0.29). Repeated angiography and embolization attempts were ineffective, and both patients died. In patients who underwent gastroduodenal and pancreatouodenal artery embolization, bleeding did not resume. Thus, we obtained good results as 6 out of 8 patients recovered (75 %), despite the severity of their condition and a disappointing prognosis (OR–9.0 [1.0–46.7], p <0.05).

Conclusions. Adherence to the tactics mentioned above in the treatment of bleeding in duodenal ulcer was highly effective, especially in superselective embolization with the detection of bleeding gel. If the presence of arosive bleeding is confirmed, emergency surgical treatment with suturing of the damaged vessel is shown in hemodynamically unstable patients, and endovascular intervention is possible in hemodynamically stable patients. Further studies are needed to determine the criteria for a high risk of arosive bleeding developing in patients with complicated duodenal ulcer as well as to prevent its occurrence through the use of X-ray endovascular interventions.


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Author Biographies

Volodymyr Mamchych, Shupyk National Medical Academy of Postgraduate Education; Kyiv Regional Clinical Hospital

Department of Surgery and Proctology

Sergiy Vereshchagin, Shupyk National Medical Academy of Postgraduate Education;Kyiv Regional Clinical Hospital

Department of Surgery and Proctology

Dmytro Maksymchuk, Shupyk National Medical Academy of Postgraduate Education; Kyiv Regional Clinical Hospital

Department of Surgery and Proctology


Tarasconi, A., Coccolini, F., Biffl, W. L., Tomasoni, M., Ansaloni, L., Picetti, E. et. al. (2020). Perforated and bleeding peptic ulcer: WSES guidelines. World Journal of Emergency Surgery, 15 (1). doi:

Garber, A., Jang, S. (2016). Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding. Clinical Endoscopy, 49 (5), 421–424. doi:

Gurusamy, K. S., Pallari, E. (2016). Medical versus surgical treatment for refractory or recurrent peptic ulcer. Cochrane Database of Systematic Reviews, 3. doi:

Ouali, S. E., Barkun, A. N., Martel, M., Maggio, D. (2014). Timing of Rebleeding in High-Risk Peptic Ulcer Bleeding after Successful Hemostasis: A Systematic Review. Canadian Journal of Gastroenterology and Hepatology, 28 (10), 543–548. doi:

Narayanan, M., Reddy, K. M., Marsicano, E. (2018). Peptic Ulcer Disease and Helicobacter pylori infection. Missouri Medicine, 115 (3), 219–224.

Tarasconi, A., Baiocchi, G. L., Pattonieri, V., Perrone, G., Abongwa, H. K., Molfino, S. et. al. (2019). Transcatheter arterial embolization versus surgery for refractory non-variceal upper gastrointestinal bleeding: a meta-analysis. World Journal of Emergency Surgery, 14 (1). doi:

Szura, M., Pasternak, A. (2015). Upper non-variceal gastrointestinal bleeding – review the effectiveness of endoscopic hemostasis methods. World Journal of Gastrointestinal Endoscopy, 7 (13), 1088–1095. doi:

Kim, K. B., Yoon, S. M., Youn, S. J. (2014). Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding. Clinical Endoscopy, 47 (4), 315–319. doi:

Jang, J.-Y. (2016). Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding. Clinical Endoscopy, 49 (5), 417–420. doi:

Barkun, A., Al Dhahab, H., McNabb-Baltar, J., Al-Taweel, T. (2013). State-of-the-art management of acute bleeding peptic ulcer disease. Saudi Journal of Gastroenterology, 19 (5), 195–204. doi:

Jafar, W., Jafar, A. J. N., Sharma, A. (2014). Upper gastrointestinal haemorrhage: an update. Frontline Gastroenterology, 7 (1), 32–40. doi:

Weber, D. G., Bendinelli, C., Balogh, Z. J. (2013). Damage control surgery for abdominal emergencies. British Journal of Surgery, 101 (1), e109–e118. doi:

Malfertheiner, P., Schulz, C. (2020). Peptic Ulcer: Chapter Closed? Digestive Diseases, 38 (Suppl. 2), 112–116. doi:

Beales, I. (2017). Recent advances in the management of peptic ulcer bleeding. F1000Research, 6, 1763. doi:

Kyaw, M., Tse, Y., Ang, D., Ang, T., Lau, J. (2014). Embolization versus surgery for peptic ulcer bleeding after failed endoscopic hemostasis: a meta-analysis. Endoscopy International Open, 2 (1), E6–E14. doi:

Craenen, E. M. E., Hofker, H. S., Peters, F. T. M., Kater, G. M., Glatman, K. R., Zijlstra, J. G. (2013). An upper gastrointestinal ulcer still bleeding after endoscopy: what comes next? Netherlands Journal of Medicine, 71 (7), 355–358.

Holster, I. L., Kuipers, E. J. (2012). Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives. World Journal of Gastroenterology, 18 (11), 1202–1207. doi:

Cerqueira, R. M., Andrade, L., Correia, M. R., Fernandes, C. D., Manso, M. C. (2012). Risk factors for in-hospital mortality in cirrhotic patients with oesophageal variceal bleeding. European Journal of Gastroenterology & Hepatology, 24 (5), 551–557. doi:

Mamchich, V. I., Vereshhagin, S. V., Maksimchuk, D. V., Maksimchuk, V. D., Chaika, M. A. (2020). Pat. No. 143527 UA. Sposib diagnostiki ta likuvannya profuznikh krovotech iz stenozuyuchikh postbulbarnikh virazok. MPK: A61B 8/12, A61B 17/00. No. u202002723. declareted: 05.05.2020; published: 27.07.2020, Bul. No. 14.

Mamchich, V. I., Maksymchuk, V. D., Maksymchuk, D. V. (2020). Classification of gastroduodenal bleeding by the strength of the bleeding jet. Actual problems of transport medicine, 3 (61), 71–78. doi:

Flati, G., Salvatori, F., Porowska, B., Talarico, C., Fiati, D., Proposito, D. et. al. (1995). Severe hemorrhagic in pancreatitis. Annali Italiani di Chirurgia, 66 (2), 233–237.

Barge, J. U., Lopera, J. E. (2012). Vascular Complications of Pancreatitis: Role of Interventional Therapy. Korean Journal of Radiology, 13 (Suppl 1), S45–S55. doi:

Boudghène, F., L’Herminé, C., Bigot, J.-M. (1993). Arterial Complications of Pancreatitis: Diagnostic and Therapeutic Aspects in 104 Cases. Journal of Vascular and Interventional Radiology, 4 (4), 551–558. doi:

Sethi, H., Peddu, P., Prachalias, A., Kane, P., Karani, J., Rela, M., Heaton, N. (2010). Selective embolization for bleeding visceral arteru pseudoaneurysms in patients with pancreatitis. Hepatobiliary & Pancreatic Diseases International, 6, 634–638.

Hyare, H., Desigan, S., Brookes, J. A., Guiney, M. J., Lees, W. R. (2007). Endovascular Management of Major Arterial Hemorrhage as a Complication of Inflammatory Pancreatic Disease. Journal of Vascular and Interventional Radiology, 18 (5), 591–596. doi:

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How to Cite
Mamchych, V., Vereshchagin, S., Maksymchuk, V., & Maksymchuk, D. (2021). Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum. EUREKA: Health Sciences, (2), 37-43.
Medicine and Dentistry