Hemostatic effect of local intramural injection of dehydrated ethanol in the canine gastrointestinal tract.
The relative value of a subserosal injection of 98% ethanol (0.2 ml x 4) in controlling acute and chronic bleeding from serosal vessels was assessed in 17 dogs. Blood flow was measured from gastric serosal vessels (average diameter, 1.6 mm) severed immediately after, 24 hours after, and 48 hours after ethanol injection. Blood flow from severed colonic serosal vessels (averaging diameter, 1.0 mm) was measured before and immediately after ethanol injection. The safety of ethanol injection was tested by endoscopically guided submucosal injections which were sequentially observed by endoscopy at 1 hour, 24 hours, and weekly for 4 weeks after injection. Ethanol injection had no effect on bleeding from larger gastric vessels unless the injection was made 24 or 48 hours prior to vessel severence. Ethanol injection was effective in reducing bleeding from the smaller colonic vessels when done immediately prior to vessel severence. Gastric submucosal injections led to ulcers which extended into the muscle layer at 1 week and were completely healed by 3 weeks; none perforated or bled. These data support the potential efficacy of therapeutic ethanol injection for the control of small vessel (1.0 mm in diameter) bleeding and the potential prophylactic value against rebleeding from larger vessels. Further studies are needed to determine whether these findings are organ related as opposed to being diameter specific.
Sugawa
C
C
Department of Surgery, Wayne State University, Detroit, Michigan 48201.
Fujita
Y
Y
Lucas
C E
CE
Raval
M
M
Masuyama
H
H
D000818:Animals; D003106:Colon / Q000098:blood supply; D004285:Dogs; D000431:Ethanol / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D005773:Gastroscopy; D006489:Hemostatic Techniques; D013270:Stomach / Q000098:blood supply
D000431:Ethanol