症例
MANTIS CDにて止血を得たEVL後胃静脈瘤再出血の一例
2026 年 108 巻 1 号 p. 73-74
詳細
2026 年 108 巻 1 号 p. 73-74
Case presentation: A 54-year-old man with a history of alcoholic cirrhosis presented to our hospital with hematemesis. Upper endoscopy revealed active bleeding from the gastric varices. Primary hemostasis was achieved with endoscopic variceal ligation (EVL). A second-look procedure revealed rebleeding from the ulcer base after EVL on the sixth day of hospitalization. Re-EVL and radiofrequency coagulation for hemostasis were deemed impractical. Hemostasis was achieved using a MANTIS Clip to invert and suture the ulcer base, then adding a SureClip to completely close the suture of the ulcer base.
Discussion: No effective treatment has been established for rebleeding after EVL of esophagogastric varices. WSB tubes or IVR-based hemostasis may be used when controlling bleeding is difficult. The structure of the MANTIS Clip differs from that of conventional clips, offering superior grasping ability and enabling hemostasis through strong compression. This finding suggests the potential of using the MANTIS Clip as an effective troubleshooting tool for treating postendoscopic rebleeding.
