2020 Volume 97 Issue 1 Pages 44-49
When hemorrhagic duodenal ulcers are untreatable by endoscopy, alternatives are surgery or intravascular treatment. However, if the patient's condition is unfavorable, these options are occasionally unavailable. We report 2 cases in which Over-the-Scope clip (OTSC) was used in place of surgery or intravascular treatment. Case 1: An 82-year-old man, admitted with postrenal failure and renal carcinoma, suffered from persistent duodenal ulcer hemorrhaging. Endoscopic hemostasis was required 6 times; therefore, OTSC was used for endoscopic closure of the duodenal ulcer. No re-bleeding occurred after treatment. Case 2: A 79-year-old man with a history of cerebral infarction and idiopathic thrombocytopenic purpura visited the ER because of tarry stools. He was diagnosed with a hemorrhagic duodenal ulcer; however, the muscle layer was partially defective. Therefore, endoscopic suturing was performed with OTSC. No adverse event occurred after treatment. The OTSC, which can grab the target mucosa more strongly and widely than conventional clips, can be an alternative when hemorrhages cannot be controlled by conventional treatments.
