Over-the-Scope Clip to the Rescue! A Novel Tool for Refractory Acute Nonvariceal Upper Gastrointestinal Hemorrhage
| Autor: | Jobin Philipose, Shivantha Amarnath, Jeffrey Abergel, Hafiz Khan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
over-the-scope clip
medicine.medical_specialty medicine.medical_treatment Salvage therapy 03 medical and health sciences refractory gastrointestinal bleed 0302 clinical medicine Refractory Risk of mortality Medicine Upper gastrointestinal Case Series angiography Embolization lcsh:RC799-869 CLIPS posterior duodenal wall ulcer computer.programming_language medicine.diagnostic_test nonvariceal bleed business.industry Gastroenterology Over the scope clip Surgery through-the-scope clip 030220 oncology & carcinogenesis Angiography lcsh:Diseases of the digestive system. Gastroenterology 030211 gastroenterology & hepatology business computer upper gastrointestinal hemorrhage |
| Zdroj: | Case Reports in Gastroenterology, Vol 14, Iss 2, Pp 261-270 (2020) Case Reports in Gastroenterology |
| ISSN: | 1662-0631 |
| Popis: | Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is more prevalent than lower gastrointestinal hemorrhage and carries a high risk of mortality in the elderly, especially those with significant cardiovascular comorbidities. Traditional endoscopic methods, such as through-the-scope clips, electrocautery, and epinephrine injection, are frequently used to control these bleeds; however, they carry a 10% risk of rebleeding, and this itself carries a mortality risk of 36%. The larger over-the-scope clips (OTSC) that were initially used for the closure of fistulas and perforations are now gradually being implemented to manage NVUGIH. To our knowledge, we present the first cases to be reported in the literature where OTSC was successfully used as salvage therapy for refractory acute upper gastrointestinal bleeders who failed traditional endoscopic management and interventional radiology-guided embolization of the bleeding artery. We also provide an up-to-date literature review on the use of OTSC and its superiority to traditional endoscopic interventions in the management of complicated NVUGIH. |
| Databáze: | OpenAIRE |
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