Snaring an adherent clot should use the same strategy as snaring a polyp. Make sure you get max capture on the first grab. #GITwitter

I always worry about what is underneath!

Why would you remove an adherent clot that’s doing its job??? All I hear in my head is the song “danger zone“

In order to treat it more durably endoscopically. The rebleeding rate is fairly high 25-30% if left alone. Guidelines leave it ambivalent whether to do this or not.

That’s a stress test for the endoscopist right there 😳

Beautiful demonstration of this technique!

You go with a cap right from the start for every bleeder?

Not always, only if I am suspecting DU. No hematemesis Melena , high BuN /Cr +NSAIDS

@EndoCollabcom 😳😳 Given how the guidelines are vague, is it your practice to always remove an adherent clot and be prepared to treat what is underneath or does it really situational?

@EndoCollabcom I almost always remove the clot and treat as I am prepared if I upgrade it to active GIB and have back up (Hemospray/IR)

.@DrBloodandGuts what cap are you using in this video?

Olympus