Incomplete hemostasis of high-risk adverse outcome bleeding lesions after placement of the over-the-scope clip: causes and solutions Ravishankar Asokkumar,

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Presentation transcript:

Incomplete hemostasis of high-risk adverse outcome bleeding lesions after placement of the over-the-scope clip: causes and solutions Ravishankar Asokkumar, MBBS, MRCP VideoGIE Volume 3, Issue 5, Pages 155-156 (May 2018) DOI: 10.1016/j.vgie.2018.02.005 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Incomplete hemostasis after placement of OTSC in high-risk adverse outcome bleeding. A, A large vessel within a fibrotic ulcer seen in the duodenal bulb. B, Use of medium-sized (17.5-mm) OTSC to capture the visible vessel. C, Active bleeding after suction, resulting in poor visualization of the bleeding site. D, Ulcer was suctioned but failed to invert completely; OTSC deployed. E, OTSC was deployed superficially, with failure to compress the bleeding vessel, causing continued bleeding (arrow). F, Epinephrine injected around the OTSC site. G, Bleeding slowed after epinephrine injection. H, Hemostatic powder was sprayed, and bleeding stopped completely. OTSC, over-the-scope clip. VideoGIE 2018 3, 155-156DOI: (10.1016/j.vgie.2018.02.005) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions