Hereditary hemorrhagic telanectasia: Massive recurrent duodenal bleeding treated by gastrectomy

Massive gastrointestinal bleeding caused by duodenal ulcer eroding into a telangectasia in a patient with hereditary hemorrhagic telangectasia, is presented. Since conservative treatment failed, truncal vagotomy and Billroth II gastrectomy were performed. No massive gastrointestinal bleeding reoccurred in a two-year follow-up. Thorough localization studies of the massively bleeding site in patients with hereditary hemmorhagic telangectasia are advocated. Appropriate surgical treatment to prevent recurrent massive bleeding is suggested as the treatment of choice.