The use of endoscopic clips in nonvariceal gastrointestinal bleeding

Endoscopic control of nonvariceal bleeding has never been completely satisfactory, despite the availability of several methods of injection and coagulation. The hemoclip, with its ability to mechanically occlude the bleeding vessel, provides an effective tool to meet this challenge. Indications for clipping include bleeding due to gastroduodenal ulcers, Mallory-Weiss tears, Dieulafoy's lesions, postpolypectomy and postpapillotomy bleeding. It is most satisfactory in the presence of active spurting bleeders or visible vessels. This article describes the clip applicator and the procedure while highlighting the technical aspects, including a few useful tips in the successful management of nonvariceal gastrointestinal bleeding.