Fig. 9.

A 59-year-old female underwent emergency CT (a…c) because of hypotension and blood loss. Unenhanced scans (a) revealed subtle hyper attenuating content of proximal duodenum (thick arrows). Arterial-phase images (b, c) showed a dot-like mucosal enhancement (arrowheads) at dorsal aspect of duodenal bulb, which corresponded to bleeding ulcer and required endoscopic clipping and transfusions. Four days later, recurrent bleeding with melaena occurred: repeated CT-angiography (d…f) showed metallic clip (thick arrows) and thin jet-like intraluminal contrast extravasation (arrowheads), which was immediately treated with local epinephrine injection