Endoscopic hemostasis using a narrow-caliber endoscope for a bleeding duodenal ulcer in a 7-month-old infant: A case report

Duodenal ulcers are rare in infants, and their endoscopic management is challenging because of anatomical factors and limited availability of hemostatic devices compatible with narrow-caliber endoscopes. Here, we present the case of a 7-month-old female infant who developed upper gastrointestinal bleeding 9 days post-cardiac surgery while receiving aspirin therapy. Emergency esophagogastroduodenoscopy revealed a bleeding duodenal ulcer with an exposed vessel. Because of the inability to advance a standard-diameter endoscope, a narrow-caliber endoscope was used. Hemostasis was achieved using scissors-type hemostatic forceps with soft coagulation. The patient recovered without bleeding recurrence. This case highlights the importance of individualized endoscopic strategies in infants and urgent need for therapeutic devices that are compatible with narrow-caliber pediatric endoscopes.