Endoscopy Atlas (C) 2005 Video Cases

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Active Bleeding Gastric Ulcer

62 year old, Schizophrenic, intellectually disabled, past left hemiparesis. Presented with unclear story ? haematemesis. Hb 119g/l. Routine same day upper GI endoscopy demonstrated this actively 'spurting' high gastric ulcer. This area was injected with adrenaline with a degree of haemostasis, following which a 'Resolution' haemostasis clip was applied with success. The patient remained stable for a 5 day period prior to being discharged.

Comments?
Injection prior to clip deployment? Often used when visibility is poor but is it necessary in this case. Other preferred ways of treating this patient?

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