A 24-year-old man was referred for further management of a large arteriovenous malformation (AVM) in the second part of his duodenum (Fig. 1). He had a long history of refractory anemia requiring regular iron infusions and recurrent episodes of gastrointestinal bleeding necessitating hospital admission. Gastroscopy at his local hospital had shown a large duodenal AVM and computed tomography angiograms performed during bleeding episodes failed to identify a vessel amenable to embolization. The patient was keen to avoid surgical resection and was referred for consideration of endoscopic management.
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