title: Endoscopic hemostasis with metallic hemoclips for iatrogenic Mallory-Weiss tear caused by endoscopic examination.
abstract: OBJECTIVE
  Applied endoscopic techniques including mucosal resection, sclerotherapy and endoscopic retrograde cholangiopancreatography (ERCP) have been advanced and iatrogenic complications including Mallory-Weiss tear (MWT) occasionally occur in daily endoscopic procedures. The present study aimed to examine the advantages of clipping for MWT complications that occur during endoscopic examination.
  
  
  METHODS
  Over 10 years, we experienced 47 patients with bleeding caused by MWT. Metallic hemoclips were applied for 38 patients for hemostasis. These patients were categorized into two groups: 18 patients in group A whose bleeding tear occurred during endoscopic examination in an iatrogenic condition, and 20 patients in group B visited the emergency unit due to other etiology of MWT.
  
  
  RESULTS
  The background characteristics, including length of tears, were not different between the two groups. Initial hemostasis was 100% in groups A and B. Rebleeding was 0/18 (0%) in group A and 1/20 (5 %) in group B. Number of patients who received blood transfusion was significantly higher in group B (group A: 0/18, group B: 4/20). Hemoglobin level before hemostasis was 12.5 g/dL in group A which was not different to that in group B, 10.9 g/dL.
  
  
  CONCLUSIONS
  Application of hemoclips was effective for bleeding MWT during endoscopic procedures, which warranted prophylactic application of hemoclips on MWT during endoscopic examination.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Saga, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ogata
authors.forename: Hibiki
authors.initials: H
authors.lastname: Ootani
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Takehiro
authors.initials: T
authors.lastname: Fujise
authors.forename: Kanako
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Mannen
authors.forename: Seichiro
authors.initials: S
authors.lastname: Arima
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shiraishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Noda
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ono
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunada
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006488:Hemostasis, Surgical; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome