The use of over the scope clip (OTSC) in cases of gastrointestinal bleeding with difficulty in hemostasis

Abstract

We present the advantages and limitations of the over-the-scope clip (OTSC) for gastrointestinal bleeding. Two cases of acute hemorrhagic rectal ulcers (AHRU) and two cases of duodenal ulcer (DU) bleeding were included. The OTSC was chosen to manage these cases due to difficulty in achieving hemostasis using conventional methods. The OTSC is advantageous because it may be used for additional cauterization without fear of perforation due to the use of full-layer sutures; furthermore, it could be used to stop the bleeding in cases where it is difficult to treat guttural vessels or the bleeding point is not identified because of the use of suction. We should be aware of the possibility of rebleeding due to gaps in tissue return and the need for additional hemostasis after OTSC when full-layer sutures are not possible.