Salvage hemostasis with endoscopic suturing for refractory transverse colonic ulcer bleeding

Gastrointestinal bleeding is a common medical emergency, with most cases effectively managed using standard endoscopic therapies such as epinephrine injection, mechanical clipping, and thermal coagulation. However, in cases where bleeding recurs despite endoscopic treatment, escalation to rescue strategies such as angiographic embolization or surgery becomes necessary. Endoscopic suturing has recently emerged as a salvage hemostatic technique before surgery [1] [2], complementing its established roles in endoscopic gastroplasty [3] and wound closure [4]. We report a case of recurrent colonic ulcer bleeding in the transverse colon that was successfully treated using an endoscopic suturing system after the failure of conventional endoscopic therapies.