title: Successes and failures of endoscopic injection haemostasis for bleeding peptic ulcers. A prospective clinical study.
abstract: 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.
authors.affiliation: Department of Surgery, Johannesburg Hospital.
authors.forename: J
authors.initials: J
authors.lastname: Lipschitz
authors.forename: G R
authors.initials: GR
authors.lastname: Gecelter
authors.forename: M G
authors.initials: MG
authors.lastname: Veller
authors.forename: J R
authors.initials: JR
authors.lastname: Botha
authors.forename: J A
authors.initials: JA
authors.lastname: Myburgh
mesh_terms: 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*
chemical_list: D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate; D004837:Epinephrine