Sent 02/23/2026 12:10:21, Page - 35

duodenum. Hemostasis was attempted by placing three Cook instinct hemoclips on the bleeding site(s) resulting in stowing down of the
bleeding. Submucosal injection of 8ml of epinephrine 1:10,000 was performed around the bieeding site with increased bleeding resulting.

Bipolar (BICAP) cautery with a 10Fr probe was applied to the site for 5 secs. With increased bleeding resulting.

ILE mae a ia i a

UNPLANNED EVENTS: There were no complications.

IMPRESSIONS: 1. The esophagus appeared normal

2. The fundus, cardia, body and antrum of the stomach all appeared normal. The stomach distended normally and the
endoscope passed easily though the pylorus into the duodenum

3. Small ulcer was found in the 1st part of the duodenum; Hemostasis was attempted by placing three hemoclips on the
bleeding site(s); Submucesal injection of 8m of epinephrine 1:10,000 was performed around the bleeding site; Bipolar

(BICAP) cautery with a 10Fr probe was applied to the site for 5 secs; with Increased bleeding resulting

RECOMMENDATIONS: IR consult

PATIENT NAME: Holand, Mark T
MR#: RCO3030788 Page 2 of 3

PAGE 35/47 * RCVD AT 2/23/2026 12:10:26 PM [Pacific Standard Time] * SVR:FAXP21/3 * DNIS:9777 * CSID: * ANI:17783680130 * DURATION (mm-ss):21-27