Telangiectasia affected Vater's papilla in Osler Rendu syndrome.

52-years-old male diagnosed of Rendu Osler syndrome (ROS) refered dark, pasty stools and anemia (Hg: 9 g/dl). The upper endoscopy revealed a duodenum mucosa with telangiectasias. Afterwards, an enteroscopy was performed and duodenum and jejunum telangiectasias were seen and treated by Argon plasma coagulation. During the procedure one telangiectasia that affected the entire Vater’s papilla (Fig. 1A) was identified and confirmed by duodenoscopy (Fig. 1B). The treatment of this particular lesion has been performed as follows: a bile duct cannulation and a subsequent sphincterotomy were done without any incidence. A plastic pancreatic stent was placed and then, the affected papilla’s area was treated by Argon coagu lation (Fig. 2A). A plastic biliary stent was placed finally. Four days after the procedure, both two stents were removed endoscopically and the disappearance of the papillary telangiectasia was confirmed (Fig. 2B). There were no early or late complications registered (period of follow up: 13 months). The patient has decreased the need for blood transfusions.