Endoscopic Hemostasis With Metallic Hemoclips for Iatrogenic Mallory‐weiss Tear Caused by Endoscopic Examination

Abstract

Application of hemoclips was effective for bleeding MWT during endoscopic procedures, which warranted prophylactic application of hemoclips on MWT during endoscopic examination.

Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial

“…The eradication of H. pylori is known to reduce the recurrence of peptic ulcers [4,5] and rehemorrhage [6]. However, upper gastrointestinal bleeding is still one of the most common and serious clinical complications of peptic ulcers [7][8][9][10][11][12][13]. In the past 25 years, various endoscopic hemostatic methods for bleeding ulcers have been developed, and endoscopic hemostasis is the first-choice treatment for upper gastrointestinal bleeding.…”

Asymptomatic Free Air Caused by Mallory-Weiss Tears during Endoscopy

“…It has been reported that MWTs may occur iatrogenically during EGD (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) and during endoscopic submucosal dissection (ESD) (15). Although iatrogenic MWTs are generally caused by retching or forceful vomiting during an EGD or ESD procedure (5,11,15), in some cases, no retching or struggling was found to contribute to the development of MWT (6), as in the present case.…”

“…In contrast, several additional therapeutic procedures may be applied for the treatment of a bleeding MWT, such as endoscopic hemoclipping, endoscopic band ligation, and endoscopic injection therapy (8,9,15,19). Penson et al emphasized the need to admit patients with iatrogenic MWTs (as in our patient) for 24 hours observation (6).…”

“…To date, there have been many reports of individuals with this clinical syndrome, and the incidence of is approximately 5-15% of all episodes of upper GI bleeding (2-4). Watts first reported that this condition occurred as a complication of esophagogastroduodenoscopy (EGD) (5) and the incidence is estimated to be 0-0.49% of EGD procedures (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). However, our perusal of the previous reports revealed that the terms "Mallory-Weiss syndrome (MWS)" and "Mallory-Weiss tears (MWTs)" were undifferentiated.…”

Effectiveness of Endoscopic Hemostasis with Soft Coagulation for Non-Variceal Upper Gastrointestinal Bleeding over a 12-Year Period

“…When a massive clot is covering the ulcer base preventing the visualization of the responsible vessel, the clot is removed using an irrigation system. Hemoclipping is performed continuously until hemostasis has been confirmed [23,25]. As to the use of absolute ethanol, it is directly injected in aliquots of 0.1-0.2 mL into areas around the bleeding vessels using an endoscopic local injection needle to a total volume of 1 mL [23,24].…”