Fig. 4.

( a ) Representative endoscopy image from initial presentation demonstrating ulceration in the duodenum with minimal bleeding. These images were captured just prior to the start of the massive bleeding episode which was not able to be controlled with endoscopic techniques. This bleeding event prompted the consult to interventional radiology for emergent transcatheter arterial embolization. ( b ) Representative endoscopy image from 3 days post transcatheter arterial embolization demonstrating ischemic changes of the mucosa in the duodenum with mild diffuse oozing.