Use of Over-the-Scope Clips in the Management of Refractory Postbanding Ulcer Bleed in a Patient After Liver Transplant

Postbanding ulcer bleeds (PBUBs) are an uncommon complication of variceal band ligation. They are often treated with proton pump inhibitors in addition to endoscopic interventions such as epinephrine injections, hemostatic clips, electrothermal cautery, or further band ligation. Over-the-scope clips are being increasingly used for the management of acute nonvariceal upper gastrointestinal bleeds, but their use in the management of PBUBs has been reported only once before. We present a 24-year-old man with alcohol-associated decompensated cirrhosis with recurrent PBUB, despite multiple endoscopic interventions, transjugular intrahepatic portosystemic shunt, and liver transplant, treated successfully with an Ovesco clip.