Atlas of Gastroenterological Endoscopy
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Forrest Ib hemorrhage under coumarine treatment Forrest Ib hemorrhage under coumarine treatment
Extensive duodenal ulcer with active bleeding grade Forrest Ib aggravated by oral anticoagulation. A submucosal injection of adrenalin ( 1:20000) has been delivered already, leaving a pale white mucosa behind. Leaving the duodenum, the antrum also shows signs of this adrenalin injection to the duodenal submucosa. Adjacent to reflux of blood to the antrum, a demarcated area of pale white mucosa is visible, which is caused by the vasoconstrictive effects of adrenalin.
Status after 6 weeksītreatment After 6 weeks the healing of the ulcer is not yet complete.