2020 Volume 34 Issue 5 Pages 840-847
An 82-year-old man was referred to the hospital because of weight loss and anemia. After various imaging tests, bile duct cancer was suspected. Endoscopic sphincterotomy (EST) was performed after definitive diagnosis using endoscopic cholangiography (ERC); hemostasis was performed because of bleeding from the incision. The next day, because of the progression of anemia, an upper gastrointestinal endoscopy was performed, revealing active bleeding at the same site. Hemostasis was obtained by applying pressure on the fully-covered metal stent. Two days later, a clot adhered to the same site; there was active bleeding upon removing the clot. Because of intractable bleeding, complete hemostasis was achieved using a combination of absorbable tissue reinforcement and fibrin adhesive materials at the site of bleeding. This method has been reported to be relatively safe for controlling bleeding after endoscopic submucosal dissection and rectal ulcer bleeding and is also considered to be useful as a hemostatic method for intractable hemorrhage after EST.
