Bleeding duodenal ulcer

Endoclip hemostasis of a bleeding duodenal ulcer after epinephrine injection. This patient began to bleed while an inpatient and required six units of packed RBC transfusion for resuscitation. After the combination hemostasis (epinephrine and hemoclips) he was treated with 72 hours with high dose proton pump inhibitor (PPI) (pantoprazole 80 mg IV bolus and 8 mg/hr IV drip, followed by twice daily oral PPI. He did not rebleed.