Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11574-11578
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11574
Gastric ulcer treated using an elastic traction ring combined with clip: A case report
Fei Pang, Yan-Jun Song, Yin-He Sikong, Ai-Jun Zhang, Xiu-Li Zuo, Ru-Yuan Li
Fei Pang, Yin-He Sikong, Ai-Jun Zhang, Ru-Yuan Li, Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shangdong University, Qingdao 266035, Shandong Province, China
Yan-Jun Song, Department of Hematology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shangdong University, Qingdao 266035, Shandong Province, China
Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shangdong University, Jinan 250012, Shandong Province, China
Author contributions: Pang F wrote this article; Sikong YH and Song YJ managed this patient’s hospitalization; Zuo XL and Zhang AJ made the diagnosis and treatment plan; Li RY performed the operation of this patient.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ru-Yuan Li, MM, Attending Doctor, Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shangdong University, No. 758 Hefei Road, Qingdao 266035, Shandong Province, China. liruyuan163@163.com
Received: June 21, 2022
Peer-review started: June 21, 2022
First decision: August 1, 2022
Revised: August 28, 2022
Accepted: September 23, 2022
Article in press: September 23, 2022
Published online: November 6, 2022
Processing time: 127 Days and 12.4 Hours
Abstract
BACKGROUND

There is a high annual incidence of acute, nonvariceal upper gastrointestinal bleeding in Chinese adults. Early endoscopic intervention can reduce rates of rebleeding, surgery, and mortality. The metal clip is the most common method for establishing homeostasis; however, it possesses several limitations. In patients with bleeding secondary to large gastric ulcers, the clip will often fail to stop the bleeding. This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.

CASE SUMMARY

An elderly male presented to the emergency room with complaints of hematemesis and melena. Endoscopic examination revealed an ulcer (Forrest IIa) in the lesser curvature of the gastric antrum. Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer. The patient recovered quickly without postoperative gastrointestinal bleeding. Two months later, the patient's ulcer was significantly healed.

CONCLUSION

To our best knowledge, this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding. Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.

Keywords: Gastric ulcer; Elastic traction ring; Acute nonvariceal upper gastrointestinal bleeding; Endoscopic hemostasia; Tissue clips; Case report

Core Tip: Acute, nonvariceal, upper gastrointestinal bleeds are common medical emergencies. Gastric ulcers often cause this condition. Early endoscopic intervention can reduce rates of rebleeding, surgery, and mortality. Presently, various methods are available for establishing endoscopic hemostasis. Metal clips are a popular method; however, they possess specific limitations. Elastic traction rings are widely used during endoscopic submucosal dissection procedures. We were the first to apply elastic traction rings for ulcer suturing for hemostasis with excellent results. We are presently evaluating the effectiveness and limitations of this hemostatic method.