Endoscopic naso‐biliary and ‐pancreatic duct drainage for refractory post‐bulbar duodenal ulcer bleeding

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Bleeding peptic ulcer is usually manageable with endoscopic hemostasis and gastric acid suppressants; however, recurrent bleeding sometimes occurs, especially in patients with comorbidities1 . A woman in her 60s who had received bone marrow transplantation for mycosis fungoides 2 months earlier received 30 mg methylprednisolone for graft-versus-host disease (GVHD). She presented with anemia and melena, and emergency esophagogastroduodenoscopy (EGD) revealed a bleeding ulcer next to the peri-ampullary diverticulum.

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