ABSTRACT A 36-year-old man presented with hematemesis. Emergency endoscopy revealed a large vessel with a red plug in the upper gastric body, mimicking gastric varices; cyanoacrylate was injected. Contrast-enhanced computed tomography revealed that the lesion was a gastric arterial malformation. Since transcatheter arterial embolization failed to completely occlude blood flow, endoscopic hand suturing (EHS) was employed to ligate the culprit artery at 2 penetrating points. Using EHS, sufficient constrictive force was exerted to occlude arterial blood flow. The patient has remained recurrence-free for 2 years. EHS could be considered a potential rescue therapy when conventional treatments are insufficient.
Ito et al. (2026) studied this question.