Indication for Procedure: This gentleman presented to the hospital with a upper GI bleed. An endoscopy severla days ago revealed a pyloric channel ulcer with no active bleeding. He has re-bled and the endoscopy is done to evaluate possible sources of bleeding.
Findings: After obtaining informed concent, the patient was premedicated with heavy sedation. The risks and benefitss of the procedure, including the risks associated with possilbe recent MI were explained to the patient. Then Pentax vido endoscope was inserted into the espohagus and advanced under direct visualization. The tubular view of the esophagus, stomach and duodenum was normal except for several shallow antral ulcers and a 1 cm ulcer in the pyloric channel with a visible vessel. This ulcer was then injected with 3 cc of 1:10,000 epinephrine. It was cauterized with the BICAP probe and and Endo Clip was placed on the ulcer. There was no bleeding at the site at the end of the procedure.
Diagnostic Impression: Upper GI bleed secondary to pyloric channel ulcer.
Help with this would be greatly appreciated.
Findings: After obtaining informed concent, the patient was premedicated with heavy sedation. The risks and benefitss of the procedure, including the risks associated with possilbe recent MI were explained to the patient. Then Pentax vido endoscope was inserted into the espohagus and advanced under direct visualization. The tubular view of the esophagus, stomach and duodenum was normal except for several shallow antral ulcers and a 1 cm ulcer in the pyloric channel with a visible vessel. This ulcer was then injected with 3 cc of 1:10,000 epinephrine. It was cauterized with the BICAP probe and and Endo Clip was placed on the ulcer. There was no bleeding at the site at the end of the procedure.
Diagnostic Impression: Upper GI bleed secondary to pyloric channel ulcer.
Help with this would be greatly appreciated.