Late-onset Life Threatening Hemorrhage of Omeprazole-Resistant Duodenal Ulcer Managed by Interventional Radiology: Report of a Case

Kazuoki Hizawa, Nobutoshi Miura, Hirofumi Hasegawa, Masayuki Kitamura, Mari Nakamori, Takayuki Matsumoto, Mitsuo Iida
2006 Internal medicine (Tokyo. 1992)  
A 67-year-old diabetic man was emergently hospitalized in our department because of a huge duodenal ulcer without visible vessels. Despite of intravenous administration of 40 mg omeprazole and fasting with intravenous nutritional support, endoscopically unmanageable massive bleeding occurred on the 8th hospital day. Emergent angiography showed extravasation of contrast media from a duodenal branch of the proper hepatic artery, and superselective arterial embolization was successfully achieved.
more » ... he patient recovered from the hemorrhagic shock and underwent subsequent successful surgery. Analysis of CYP2C19 enzyme genotype indicated the patient was a homozygous extensive metabolizer, considered a poor responder for omeprazole treatment.
doi:10.2169/internalmedicine.45.1721 pmid:16908943 fatcat:un4jwvcbivhtbipnoh4zgr3hvm