Mechanism of action of injection therapy for bleeding peptic ulcer.
The effects of intramucosal injection of 1:100,000 adrenaline, 5 per cent ethanolamine and normal saline were determined in experimentally created, acutely bleeding gastric mucosal wounds in rabbits. The mean(s.d.) bleeding rate was decreased from 2.3(0.4) to 0.2(0.02) ml/min by adrenaline (P < 0.01), but increased by 1 ml 5 per cent ethanolamine to 4.0(0.6) ml/min (P < 0.05). Normal saline had no haemostatic effect, suggesting that local tamponade is not important. In separate experiments endoscopic injections of 5 per cent ethanolamine, 1:100,000 adrenaline and normal saline were made in the gastric antrum of rabbits. After 48 h the degree of inflammation was greatest with ethanolamine but, despite tissue necrosis and venous thrombosis, neither endarteritis nor arterial thrombosis occurred. Injections of 5 per cent ethanolamine and 80 per cent ethanol placed next to the ear arteries of rabbits caused local ulceration and necrosis, but endarteritis and arterial thrombosis were again absent.
Rajgopal
C
C
Gastro-Intestinal Unit, Western General Hospital, Edinburgh, UK.
Lessels
A
A
Palmer
K R
KR
D000818:Animals; D001760:Bleeding Time; D004195:Disease Models, Animal; D004837:Epinephrine / Q000008:administration & dosage*; D019856:Ethanolamine; D004983:Ethanolamines / Q000008:administration & dosage*; D005753:Gastric Mucosa / Q000187:drug effects / Q000293:injuries / Q000473:pathology; D007267:Injections; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D011817:Rabbits; D013276:Stomach Ulcer / Q000188:drug therapy
D004983:Ethanolamines; D019856:Ethanolamine; D004837:Epinephrine