Penetrating Duodenal Ulcer from Hepatic Artery Chemotherapy Infusion Catheter: Successful Conservative Medical Management

A 45-year-old woman receiving continuous infusions of 5-fluoro-2'-deoxy-uridine into the hepatic artery through a surgically implanted intraarterial catheter for hepatic metastases from adenocarcinoma of the colon, developed acute epigastric pain and anemia. Endoscopy demonstrated a duodenal ulcer with a portion of the catheter visible in the crater. Conservative management with sucralfate and ranitidine allowed endoscopically proven healing of the penetrating ulcer with subsequent successful reuse of the catheter.