Successes and failures of endoscopic injection haemostasis for bleeding peptic ulcers. A prospective clinical study.
Fifty-two consecutive patients with upper gastrointestinal haemorrhage, shock (systolic blood pressure less than 100 mmHg) and a peptic ulcer showing endoscopic stigma of recent haemorrhage underwent attempts at endoscopic haemostasis. The ulcers were injected with a dilute solution of adrenaline followed by 5% ethanolamine oleate. Active bleeding was present in 22 patients (42%) at initial endoscopy. Bleeding was controlled in 40 patients (77%) in hospital. Failure occurred more frequently in duodenal ulcers than gastric ulcers (46% v. 7%; P < 0.004), and in giant (more than 2 cm diameter) duodenal ulcers (6/7) than smaller duodenal ulcers (3/15). We recommend early surgery for large posterior duodenal ulcers in preference to endoscopic injection methods.
Lipschitz
J
J
Department of Surgery, Johannesburg Hospital.
Gecelter
G R
GR
Veller
M G
MG
Botha
J R
JR
Myburgh
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004384:Duodenoscopy; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000008:administration & dosage*; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D012597:Sclerosing Solutions / Q000008:administration & dosage*
D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate; D004837:Epinephrine