A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Superficial non-ampullary duodenal tumors (SNADTs) are defined as adenomas or adenocarcinomas in the duodenum that did not originate from the ampulla of Vater and are limited to the mucosal/submucosal layer. 1,2 The incidence of SNADT among patients who underwent duodenoscopy is 0.03% to 0.4%. 3 Although primary duodenal carcinomas are rare, the prognosis of advanced duodenal carcinomas is very poor. 4 Thus, early detection and treatment is crucial. Although the standard therapy for SNADT has yet to be established, endoscopic resection (ER) has shown to be beneficial for patients with SNADT. 5-8 When mucosal defects occur after ER, pancreatic juice and bile acid may act as offensive agents and cause complications like delayed bleeding and delayed perforation. 9,10 According to a previous report, the incidence of delayed perforations after ER for SNADT is 6.3%. 11 To prevent these complications, prophylactic procedures, such application of glycolic acid sheets, coagulation of visible vessels, and endoscopic clipping, have been introduced. 12-18 However, previous reports on these procedures had several limitations: most of the studies were performed in single centers and heterogenous disease entities were included. Because of this, the prophylactic effects of endoscopic clipping have not been well-established. This study aimed to investigate the effects of prophylactic clipping

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Mucosa-associated lymphoid tissue (MALT) lymphomas most commonly occur in the stomach and rarely in the duodenum. Gastric MALT lymphoma is usually associated with <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection that may be cured by eradication. However, duodenal MALT lymphoma is not associated with <i>H. pylori</i> infection. Moreover, the pathophysiology and treatment methods for duodenal MALT lymphoma have not yet been established because the disease is rare. Here, we report a case of duodenal MALT lymphoma. A 58-year-old man was treated for a refractory duodenal ulcer. Based on repeated biopsy, a diagnosis of MALT lymphoma was made. The patient achieved complete remission after chemotherapy and was followed up without recurrence for three years.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. A 77-year-old man was referred for the evaluation of general weakness and leukocytosis. Computed tomography showed a 9.5×6.5-cm cavitary lesion with an air-fluid level near the stomach, which was thought to be a perigastric abscess. Upper endoscopy revealed a fistula on the greater curvature at the mid body of the stomach. The margin of the fistula opening was clearly demarcated, and yellow turbid fluid oozing from the fistula was seen. Laparoscopic wedge resection was performed at the perforated area of the stomach.