We report a patient with enlargement of anastomotic ulcer after clippings hemostasis. A 40-year-old man was admitted to our hospital complaining of hematemesis on July 30, 1994. He was received distal partial gastrectomy for bleeding from duodenal ulcer at age 38.
Emergency endoscopic examination revealed an anastomotic ulcer with active bleeding in site of the jejunum. The bleeding was successfully controled by endoscopic clippings hemostasis. Endoscopic examination revealed enlargement of the ulcer from posterior wall to upper wall on the 3rd day.
A case with bleeding gastrointestinal ulcer which was enlarged after clippings hemostasis has never been reported in Japan. This was the first case with bleeding gastrointestinal ulcer which was enlarged after clippings hemostasis. It is suggested that clippings hemostasis may disturb the supply of blood to the submucosal layer as same as in pure ethanol injection.
