What question did this study set out to answer?

The aim is to illustrate an effective approach to manage post-endoscopic variceal ligation rebleeding.

June 21, 2026Open Access

A case of post-EVL re-bleeding achieved with hemostasis using MANTIS CD

YNYu NomuraYokohama Rosai Hospital NONaoya OkadaTeine Keijinkai Hospital

Key Points

The aim is to illustrate an effective approach to manage post-endoscopic variceal ligation rebleeding.
A 54-year-old man with a history of alcoholic cirrhosis presented with hematemesis and was treated with endoscopic variceal ligation.
After rebleeding from the ulcer base, various hemostatic techniques were assessed, but MANTIS Clip and SureClip were ultimately used for closure.
Primary hemostasis was achieved with endoscopic variceal ligation, effectively managing initial bleeding.
Rebleeding occurred post-EVL, necessitating alternative hemostatic methods.
Successful hemostasis was achieved using MANTIS Clip and SureClip at the ulcer base.

Abstract

Case presentation: A 54-year-old man with a history of alcoholic cirrhosis presented to our hospital with hematemesis. Upper endoscopy revealed active bleeding from the gastric varices. Primary hemostasis was achieved with endoscopic variceal ligation (EVL). A second-look procedure revealed rebleeding from the ulcer base after EVL on the sixth day of hospitalization. Re-EVL and radiofrequency coagulation for hemostasis were deemed impractical. Hemostasis was achieved using a MANTIS Clip to invert and suture the ulcer base, then adding a SureClip to completely close the suture of the ulcer base.

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