Case Report
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 7, 2013; 19(17): 2723-2726
Published online May 7, 2013. doi: 10.3748/wjg.v19.i17.2723
Accurate hemostasis with a new endoscopic overtube for emergency endoscopy
Hirohito Mori, Hideki Kobara, Shintaro Fujihara, Noriko Nishiyama, Makoto Oryu, Kazi Rafiq, Tsutomu Masaki
Hirohito Mori, Hideki Kobara, Shintaro Fujihara, Noriko Nishiyama, Makoto Oryu, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Kagawa 761-0793, Japan
Kazi Rafiq, Departments of Pharmacology, Kagawa Medical University School of Medicine, Kagawa 761-0793, Japan
Author contributions: Mori H was responsible for conception of the research and for drafting the article; Kobara H, Fujihara S, Nishiyama N, Oryu M, and Rafiq K participated equally in the work; Masaki T provided critical revision of the manuscript for intellectual content and was responsible for final approval of the manuscript.
Correspondence to: Hirohito Mori, MD, PhD, Departments of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan. hiro4884@med.kagawa-u.ac.jp
Telephone: +81-87-8912156 Fax: +81-87-8912158
Received: February 16, 2013
Revised: March 8, 2013
Accepted: March 21, 2013
Published online: May 7, 2013
Processing time: 79 Days and 14.3 Hours
Abstract

Endoscopic hemostasis performed in the emergency room is difficult due to the presence of blood clots and food residue that makes obtaining a clear view of the bleeding vessel difficult. We experienced the efficacy of a newly developed inverted overtube to shorten the hemostatic time and obtain a clear endoscopic view with upper gastrointestinal bleeding patient who were transferred by ambulance car and required emergency endoscopy. The technique improved the endoscopic views and enabled us to perform the hemostatic procedures from the conventional standing position while freely and easily changing the patient’s position. The presence of blood clots and food residue in the gastric fornix or upper gastric body makes identifying a bleeding exposed vessel impossible. This set-up significantly shortened the procedure time. The inverted overtube helped us obtain a clear view in patients who were laid in the right lateral position. Rapid identification of exposed vessels resulted in success of hemostasis.

Keywords: Emergency endoscopic hemostasis; Right lateral decubitus position; Identification of exposed vessel; Newly developed inverted overtube; Clear endoscopic view

Core tip: The inverted overtube helped us obtain a clear view in patients who were laid in the right lateral position. Rapid identification of exposed vessels resulted in success of hemostasis.