2026 Volume 68 Issue 1 Pages 41-47
A 90-year-old man with bloody stools was admitted to our hospital in April 2023. Active bleeding was observed in the diverticulum at the end of the ileum, and hemostasis was achieved using endoscopic clipping. Endoscopic treatment was difficult due to the narrow working space of the ileum. Fortunately, the bleeding stopped, and the patient was discharged. However, the bleeding recurred. Each time, a detailed endoscopic examination was performed; however, the source of bleeding could not be identified. The patient was admitted for the fourth time because of bloody stools in January 2024. Active bleeding was found in the same area as the ileal diverticulum, where hemostasis was achieved for the first time with an over-the-scope clip (OTSC).
OTSCs have been reported to have a strong hemostatic effect and are safe for the treatment of colonic diverticular bleeding. It is also thought to be useful for the treatment of ileal diverticular bleeding. Here, we report a case of ileal diverticulum bleeding where endoscopic clipping failed due to rebleeding, but hemostasis was achieved with an OTSC. Treatment with OTSC is relatively easy, even in areas where the working space is insufficient, such as the ileum. Here, we report on the procedure with a video.
