Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants

Figure 4

A case treated with DOACs in which postoperative hemorrhage occurred twice after EMR. (a) A 76-year-old man receiving apixaban with no antiplatelets and hemodialysis. A nonpolypoid lesion 25 mm in size on the transverse colon. (b) EMR was performed. (c) Endoscopic clipping was performed in the EMR ulcer. (d) Postoperative hemorrhage occurred two days after EMR. One previous endoscopic clipping remained in the EMR ulcer. (e) Endoscopic clipping was performed again for hemostasis. (f) Postoperative hemorrhage occurred a second time three days after EMR. Endoscopic clipping was performed again, and no recurrent postoperative hemorrhage occurred after this round of hemostasis.

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