"Pseudo-target sign" after endoscopic mucosal resection in the upper GI tract

sodes of rebleeding, and he was discharged home in stable condition. This case is interesting for several reasons. First, it adds to the growing clinical experience with this novel device. The OTSC system is an innovative clipping device made of superelastic biocompatible nitinol. 1-3 Because of its size and the use of cap and tissue graspers (forceps or anchor), the OTSC system allows for the entrapment of larger amount of tissue, provides high stability and closure, and exerts minimal strain on the surrounding tissue. 1-3 Second, we show that the OTSC was effective to obliterate a large bleeding vessel in a fibrotic ulcer. These types of ulcers are very hard to treat endoscopically. Often, standard clips just fall off from these lesions and also induce more bleeding by lacerating the vessel. Although heater probe is a proven method to treat lesions similar to those presented in this case, this modality is mainly available in the United States and some Asian countries. Also, heater probe can result in perforation. 4 Finally, we show that the placement of such a clip is easy and can be very rapidly performed during an emergent EGD, resulting in potentially lifesaving hemostasis.