case_images: PMC10752134_01
case_images: Antral ulcer before (a) and after (b) endoscopic clipping.
case_images: 10.1177_26317745231220477-fig1.jpg
case_images: PMC10752134_01_10.1177_26317745231220477-fig1.jpg
case_images: fig1-26317745231220477
case_images: He was started on intravenous esomeprazole infusion and underwent an oesophagogastroduodenoscopy (OGD) which showed two antral ulcers; one had a clean base and another one had a visible vessel and a clot at the base of the ulcer [Figure 1(a)]. The ulcer with an adherent clot was injected with 2 ml of 1 in 10,000 adrenaline and an OVESCO OSTC clip was placed over the ulcer to secure haemostasis [Figure 1(b)].
case_images: Intramural haematoma viewed on endoscopy (a) and on CT imaging (b).
case_images: 10.1177_26317745231220477-fig2.jpg
case_images: PMC10752134_01_10.1177_26317745231220477-fig2.jpg
case_images: fig2-26317745231220477
case_images: A repeat OGD was done and the endoscopic findings were as shown in Figure 2(a). He also underwent a computed tomography (CT) mesenteric angiogram [Figure 2(b)]. In Figure 2(b), the blue arrow points to the haematoma and the red arrow points to the OVESCO clip.
case_images: (a) Coil embolisation and (b) Mucosal defect after resolution of haematoma.
case_images: 10.1177_26317745231220477-fig3.jpg
case_images: PMC10752134_01_10.1177_26317745231220477-fig3.jpg
case_images: fig3-26317745231220477
case_images: The patient underwent prophylactic coil embolization of the distal GDA, right gastroepiploic artery and medial branch of GDA leading towards the OVECSO clip [Figure 3(a)]. Another OGD 3 days later showed the clip still in situ but the previous haematoma had evacuated leaving a large clean-based mucosal defect [Figure 3(b)].