An Uncommon Upper Gastrointestinal Bleeding

Question: A 56-year-old man was admitted because of persistent melena for 20 days. The melena occurred 4–5 times per day, and there was no hematemesis. He was treated in a local hospital initially and the gastroscopy showed oozing bleeding in the duodenal mucosa. Hemostasis with metal clips during endoscopy and medicine treatment including proton pump inhibitors and somatostatin failed. Therefore, he was transferred to our hospital. He was diagnosed as having hepatolithiasis and had received partial hepatectomy and cholangioenterostomy 12 years ago.