case_images: PMC4195354_01
case_images: The clot in the esophagus at the site of the primary hemostasis.
case_images: CRIGM2014-972765.001.jpg
case_images: PMC4195354_01_CRIGM2014-972765.001.jpg
case_images: fig1
case_images: The clot in the esophagus was observed at the site of the primary hemostasis (Figure 1).
case_images: Failure of endoscopic clipping: misplacement of clips with the occurrence of bleeding.
case_images: CRIGM2014-972765.002.jpg
case_images: PMC4195354_01_CRIGM2014-972765.002.jpg
case_images: fig2
case_images: Boston Scientific, Natick, Massachusets, USA) were deployed but misplaced (Figure 2) due to the constant retching of the patient during the procedure. Based on our previous experience on combined use of clips and detachable snare, we decided to use the same approach.
case_images: Hemostasis achieved after application of a combined use of clips and loops ("the tulip-bundle.")
case_images: CRIGM2014-972765.003.jpg
case_images: PMC4195354_01_CRIGM2014-972765.003.jpg
case_images: fig3
case_images: Tokyo, Japan) and haemostasis was achieved by tightening the clips in a purse-string fashion (Figure 3). The postprocedural recovery of the patient was uneventful, and he was discharged from the hospital five days later.