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We report a very rare case and probably the first from India of gastric outlet obstruction due to a large intramural duodenal hematoma following combination endotherapy with hemoclipping and injection adrenaline 1:10,000 for actively bleeding duodenal ulcer in an elderly male patient with diabetes, hypertension, and end.stage renal disease on maintenance hemodialysis. The patient improved to approximately 6 weeks of conservative treatment with nasojejunal feeding.