A narcotic is given intravenously while the vital signs and arterial oxygen saturation are continuously monitored. Gastroscopy is performed using a large channel videoscope. Figure 1 is a view of the fundus of the stomach showing multiple erosions. The erosions appear shallow endoscopically, but actually are deep, extending beyond the muscularis mucosa Correct Answer 5 . The duodenum is then entered with the gastroscope.
Blood is present in the lumen.
Just as you are deciding whether or not to lavage, you visualize active spurting of blood from the anterior wall of the duodenal cap, as shown in Figure 2. Correct Answer 6 . Your mentor says that in this situation he is most comfortable using an injection technique. A disposable 1.8 mm sclerotherapy catheter sheathing a 23 gauge retractable needle is then handed to you. The nurse asks which solution you wish to use.