{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:10:04Z","timestamp":1756311004542,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,10,7]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>A man in his late 60s with prior Hartman\u2019s procedure underwent colostomy takedown and complex ventral hernia repair. He subsequently developed gastrointestinal (GI) bleeding from a duodenal bulb ulcer. Despite five endoscopic procedures aimed at achieving haemostasis, including placement of an over-the-scope clip, and four endovascular embolisations (inferior and superior pancreaticoduodenal, right gastroepiploic and gastroduodenal arteries), the patient continued to experience episodic, haemodynamically significant bleeding. He eventually required emergency exploratory laparotomy, where the proper hepatic artery was identified as the source (a previously unreported phenomenon). He underwent antrectomy and proper hepatic artery ligation. This case highlights the need to interrogate all portions of the hepatic vasculature in the treatment of refractory GI bleeding.<\/jats:p>","DOI":"10.1136\/bcr-2022-249523","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T11:05:26Z","timestamp":1667214326000},"page":"e249523","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Hepatic arterial haemorrhage caused by duodenal ulcer"],"prefix":"10.1136","volume":"15","author":[{"given":"Seamus","family":"Caragher","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny","family":"Wang","sequence":"additional","affiliation":[{"name":"General Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philicia","family":"Moonsamy","sequence":"additional","affiliation":[{"name":"General Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Fagenholz","sequence":"additional","affiliation":[{"name":"Trauma, Emergency Surgery & Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"2025082708384410000_15.10.e249523.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61825-9"},{"key":"2025082708384410000_15.10.e249523.2","doi-asserted-by":"crossref","first-page":"151560","DOI":"10.1016\/j.aanat.2020.151560","article-title":"Endoscopic projection of the gastroduodenal artery: anatomical implications for bleeding management","volume":"232","author":"Wilhelm","year":"2020","journal-title":"Ann Anat"},{"key":"2025082708384410000_15.10.e249523.3","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1177\/000331977202300907","article-title":"Peptic erosion of the cystic artery. 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