Perforation of a bleeding polypectomy site in the colon using a Hemoclip

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Arthur Hoffmann, Wiesbaden


Sequence 1 — demonstration of the resection site

A patient who had undergone polypectomy of a flat polyp in the ascending colon presented again with peranal hemorrhage. The polypectomy site can be seen in the ascending colon, with a large coagulum. The decision was taken to place a Hemoclip.

Sequence 2 — attempted clip application with perforation

A small perforation occurs during the attempt to place the Hemoclip.

Sequence 3 — introduction of an Over-The-Scope Clip (OTSC)

After an OTSC has been mounted, the site is returned to, and a macroscopic check is made to see whether the OTSC clip is large enough to suction the entire polypectomy site.

Sequence 4 — releasing the OTSC clip

After prolonged suction, the tissue area is successfully suctioned into the OTSC clip and the clip is successfully released. The site is adequately closed.

Sequence 5 — Follow-up check

Checking of the site after three clinically unremarkable days for the patient, who was receiving antibiotic treatment and gradually resuming food intake. Good results, with tight sealing of the perforation site.

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