Bleeding " XXXX : a case report.

@entity1 @entity455 @entity548 @entity75 @entity360 @entity9317
INTRODUCTION: @entity75 is an uncommon but important cause of @entity360 in which @entity548 occurs from a pinpoint, @entity455 . DLs are usually located in the stomach, most commonly in @entity1 between the ages of 50 and 70 years. In this report, we describe a teenage @entity1 with an unusual presentation of a @entity548 duodenal @entity75 that resembled the @entity9317 . CASE PRESENTATION: An 18-year-old Pakistani @entity1 presented to our emergency department with hematemesis of 6 hours' duration. Her past medical history was unremarkable. A nasogastric aspirate was negative for blood. The @entity1 's hemoglobin was found to be 4g/dl. She was resuscitated with intravenous fluids and blood transfusion. An esophagogastroduodenoscopy was performed, which revealed swelling in the first part of the duodenum, the initial appearance of which suggested that it was an abnormally placed or accessory papilla. There was a small, <3-mm opening on the lesion that resembled the biliary or pancreatic orifice. On gentle manipulation with a catheter, blood spurted from the swelling area, and a vessel was visible. Adrenaline was used for hemostasis. After hemostasis was achieved, it became clear that the lesion was most consistent with a @entity75 and not a papilla. Band ligation was then performed, and the @entity1 did not develop any complications and did not have any further episodes of @entity548 . The @entity1 was eventually discharged to home in stable condition. CONCLUSIONS: This case report highlights the importance of considering a DL as a cause of small-bowel @entity548 and recognizing its potential resemblance to the papilla. Although the endoscopic diagnostic criteria for a @entity75 have been described in great detail, there is a paucity of literature describing a @entity75 or a similar lesion resembling the @entity9317 .
