Utility of Dual Red Imaging for Endoscopic Hemostasis of Gastric Ulcer Bleeding

Abstract

Dual red imaging (DRI; Red Dichromatic Imaging (RDI)) is a new type of image-enhanced endoscopy composed of two long wavelengths that together can visualize vessels in the deep submucosa of the gastrointestinal wall. We treated a case of gastric ulcer bleeding in which the bleeding point could be clearly visualized using DRI. A 71-year-old man who was taking warfarin for atrial fibrillation noticed tarry stool, entered a state of hypovolemic shock, and underwent emergency esophagogastroduodenoscopy. The procedure was performed with a GIF-Y0058 prototype endoscope (Olympus Co., Tokyo, Japan) equipped with a DRI mode. An ulcer with active bleeding was found in the upper portion of the stomach, but the massive volume of the bleeding made it difficult to identify the bleeding point using white light imaging (WLI). Upon switching to DRI mode by pushing a button on the endoscope, the bleeding point could be identified rapidly and precisely, as it appeared in a deeper yellow than the surrounding area. Complete hemostasis was thereupon achieved. This case demonstrates that the DRI mode may be useful for detecting bleeding points that are difficult to detect using WLI.

Endoscopic submucosal dissection and tunneling procedures using novel image-enhanced technique

“…The utility of RDI for the identification and management of GI bleeding has been demonstrated in several case reports. 6 , 7 , 8 , 9 In the present study, RDI helped in identification of the bleeding site, enabling prompt hemostasis in 1 attempt in the majority of cases ( Fig. 4 ).…”

Red dichromatic imaging in peroral endoscopic myotomy: a novel image-enhancing technique

“… 1 Furuichi et al 2 reported that RDI increases the visibility of esophageal varices and red color signs and also predicts the depth of esophageal varices by changing degrees of visibility. Kubosawa et al 3 reported that in the presence of active bleed from a gastric ulcer, the bleeding point was better visualized with DRI and led to prompt hemostasis. DRI is useful in the presence of a spurting hemorrhage from a duodenal ulcer; bleeding point is noted as deep yellow, leading to clear identification of the bleeding point.…”

Development and clinical usefulness of a unique red dichromatic imaging technology in gastrointestinal endoscopy: A narrative review

“…Kubosawa et al . 16 and Tanaka et al . 17 reported on the usefulness of RDI in endoscopic hemostasis of gastric and duodenal bleeding, respectively.…”