[Sclerotherapy with 75% ethanol in the control of hemorrhage caused by peptic ulcer disease].
We present our experience using ethanol as sclerosant of non-variceal bleeding lesions of the upper digestive tract and the result of its hemostatic effect when compared with patients who received conventional medical treatment. Since January 1989, 48 patients admitted with active bleeding or signs of high risk for rebleeding (clot or visible vessel) were submitted to sclerosis. The historic control group included patients admitted before 1989, being both groups comparable in clinical and endoscopic characteristics. Surgery was performed in 5 cases of the sclerosis group (10.4%) versus 14 of the control group (37.8%). Five of the patients in the sclerotherapy group died, one of them due to upper G.I. bleeding as the primary cause. We dit not observe a statistically significant difference in hospital stay, transfusion requirements or mortality. There were no complications as a result of the method. Sclerotherapy was not immediately effective in 2 patients; three patients who rebled were subject to new sclerosis, which was effective in controlling bleeding in two of them. In conclusion, sclerosis is a safe and effective method to achieve hemostasis, diminishing the re-bleeding and the need for surgery in cases of digestive bleeding due to peptic ulcer disease. Future studies using larger samples could show decrease in mortality.
Cifuentes
C
C
Servicio de Gastroenterología Hospital General del Este Dr. Domingo Luciani IVSS, Caracas.
Mavares
J
J
Ramírez
F
F
Voso
J
J
Monasterios
W
W
Hinestrosa
H
H
Quiros
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D004381:Duodenal Ulcer / Q000150:complications; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D015911:Sclerotherapy; D013276:Stomach Ulcer / Q000150:complications
D000431:Ethanol
Escleroterapia con etanol al 75% en el control de la hemorragia por enfermedad ulcero-péptica.