Syed Jafri

Cap-assisted endoclip placement for recurrent ulcer hemorrhage after repeatedly unsuccessful endoscopic treatment and angiographic embolization: case report

The endoscopic management of patients with bleeding ulcer has advanced substantially during recent decades. Hemostasis is achieved in most patients with bleeding ulcer. However, recurrent hemorrhage remains a significant challenge. The rate of recurrent bleeding has remained essentially unchanged, at approximately 20% over the last decade. For most lesions, recurrent bleeding is readily treatable, although those in certain anatomic sites are not easily accessible for endoscopic therapy, and the risk of perforation increases with repeated thermal coagulation. Alternatives to endoscopy include surgery and angiography with embolization. This report describes a patient with recurrent bleeding from a gastric ulcer under the incisura, despite 3 prior endoscopic hemostatic therapies and angiographic embolization, that was controlled by cap-assisted hemoclip application.

A prospective comparison of enteroclysis and capsule endoscopy in the diagnosis of obscure gastrointestinal bleeding

Purpose: Enteroclysis is considered the gold standard for evaluation of small bowel diseases. Small bowel series is preferred because of its simplicity and lack of patient (pt) discomfort. Recently, capsule endoscopy (CE) was shown to be superior to small bowel radiography for evaluation of small bowel diseases. (Gastroenterol 2002; 123; 999–1005) This study was undertaken to prospectively study the diagnostic yield of enteroclysis compared with CE in pts with obscure gastrointestinal bleeding.

Cap assisted endoclipping of refractory bleeding from peptic ulcer

Bleeding that recurs despite repeated endoscopic hemostatic therapeis requires surgery. We describe a case of bleeding peptic ulcer that was refractory to conventional hemostasis, where cap assisted endoscopy combined with hemoclipping achieved successful hemostasis.