Over-the-Scope Endoscopic Clip as Rescue Therapy for Massive Esophageal Variceal Bleeding
Abstract
Postbanding ulcer bleeding is a challenging complication of endoscopic variceal ligation (EVL), particularly when standard rescue therapies fail or are unavailable. We report a 45-year-old man with decompensated cirrhosis who presented with massive hematemesis 2 weeks after EVL. Endoscopy revealed active bleeding from a deep postbanding ulcer overlying a large esophageal varix. Repeat EVL was unsuccessful, and transjugular intrahepatic portosystemic shunt or stent placement was not accessible. An over-the-scope clip (OTSC) was deployed, achieving immediate hemostasis and stable short-term outcomes. Although the patient later died of unrelated complications, this case highlights OTSC as an effective salvage option for severe postbanding ulcer bleeding.
Fields of Study & Subjects
Liver Disease and Transplantation
Gastrointestinal Bleeding Diagnosis and Treatment
Esophageal and GI Pathology
Publication details
- Journal / source
- Gastro Hep Advances
- Publisher
- Elsevier BV
- Volume
- 5
- Issue
- 4
- Pages
- 100884–100884
- Publication date
- 1 January 2026
- Language
- EN