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Recurrent gastrointestinal haemorrhage from the distal duodenum
  1. M H Holtmann1,
  2. T Keller2,
  3. P R Galle3,
  4. R Kiesslich3
  1. 11st Department of Medicine, Johannes Gutenberg-University, Mainz, Germany
  2. 2Department of Vascular Surgery, Johannes Gutenberg-University, Mainz, Germany
  3. 31st Department of Medicine, Johannes Gutenberg-University, Mainz, Germany
  1. Correspondence to:
    Dr M Holtmann
    1st Department of Medicine, Johannes Gutenberg-University, Langenbeckstrasse 1, 55 131 Mainz, Germany; mholtman{at}mail.uni-mainz.de

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Clinical presentation

In October 2004, a 69 year female patient presented with melena and anaemia (haemoglobin level 9 g/dl). The patient had been on warfarin due to construction of an aorto-bifemoral graft because of an aortic aneurysm and an …

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