SECONDARY ULCER PERFORATION AFTER ENDOSCOPIC BLOOD-STAUNCHING WITH FIBRIN SEALING

Emergency treatment of bleeding ulcer of the duodenum is endoscopy and endoscopic blood-staunching. In high-risk patients with Forrest Ia le sions or ulcers with visible vessel (Forrest Ia) endoscopic follow-up or early elective operation is required. Fibrin sealing can improve th e results of endoscopic injection therapy for bleeding ulcer. Neverthe less, severe complications such as secondary perforation of the fibrin clot or recurrent bleeding can occur. Identification of highrisk pati ents and complications requires close monitoring and attention. A case of a secondary perforation of a bleeding ulcer of the duodenum after fibrin sealing is reported.