Endoscopic Ultrasound-Guided Gastric Remnant Access for Massive Upper Gastrointestinal Bleeding in Roux-en-Y Anatomy
Abstract
This case reports a novel and successful attempt at identifying and treating massive upper gastrointestinal bleeding in an unstable patient with Roux-en-Y anatomy via endoscopic ultrasound-directed transgastric intervention and over-the-scope clip placement. The remnant stomach was located under endoscopic ultrasound and accessed via gastrogastrostomy, which was created via lumen-apposing metal stent placement. The lesion was identified, and hemostasis was achieved with epinephrine injection and over-the-scope clip deployment. The patient made a full recovery with a healed lesion at outpatient follow-up. This method can pave the way for future improvement in minimally invasive treatment modalities for patients with altered gastrointestinal anatomy.
Fields of Study & Subjects
Gastrointestinal Bleeding Diagnosis and Treatment
Gallbladder and Bile Duct Disorders
Minimally Invasive Surgical Techniques
Publication details
- Journal / source
- ACG Case Reports Journal
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Volume
- 13
- Issue
- 1
- Pages
- e01949–e01949
- Publication date
- 1 January 2026
- Language
- EN