An Uncommon Complication of Transoral Incisionless Fundoplication

In this report, we present a case in which a patient developed hemodynamic instability and melena two days after transoral incisionless fundoplication (TIF), a procedure perceived to have a safer adverse event profile. After the patient was stabilized, repeat esophagogastroduodenoscopy showed a Forrest IIa ulcer on the gastric cardia at the suture site, which was cauterized and resolved. This case highlights that significant hemorrhagic events can occur after a TIF procedure and reviews approaches to anticipate this rare occurrence and steps to prevent it.