Use of over-the-scope clip for ulcer hemostasis after failure of both surgery and interventional therapy

Abstract

Rationale: Non-variceal gastrointestinal bleeding is a common critical disease worldwide, and according to relevant guidelines, surgery and interventional treatment are the final therapies. However, few studies have reported on therapeutic strategies to employ when the ultimate treatment fails. This report offers a reasonable option for hemostasis after surgery and interventional treatment both fail. Patient concerns: A 47-year-old man with recurrent bleeding had undergone endoscopy, surgery, and interventional therapy; however, effective hemostasis was not achieved. Diagnosis: This patient's clinical manifestations and typical gastroscopic findings confirmed duodenal bulb ulcer with hemorrhage Interventions: A Billroth II + Bancroft operation, interventional treatment, and endoscopic hemostasis with an over-the-scope clip (OTSC) system were administered. Outcomes: The bleeding was successfully controlled, and the patient remained well during long-term follow-up. Lessons: The OTSC system can represent a reasonable option for ulcer hemostasis after surgery when other interventional therapies have failed.