[Endoscopic hemostasis of hemorrhagic gastroduodenal ulcers].
The mortality rate for peptic ulcer bleeding has remained constant for several decades, despite advances in surgery and intensive care, and this has given rise to an interest in therapeutic hemostatic endoscopy. Thus, endoscopy in the treatment of peptic ulcer hemorrhage would be undertaken with the aim of obtaining an early and precise diagnosis of the hemorrhagic lesions, to arrest active bleeding and/or to prevent rebleeding. In the selection of patients justifying an endoscopic hemostatic treatment, intervene clinical criteria (age, concomitant pathologies, current medication, hemodynamic parameters), endoscopic criteria (active arterial bleeding, visible vessels). The most frequently employed methods are laser photocoagulation, thermal probe cauterization, electrocoagulation and sclerotherapy. None of these methods have gained supremacy. There is consensus that sclerotherapy should be the method of reference (simple and inexpensive). Endoscopic methods are capable of arresting bleeding and constitute an alternative method to surgery in cases of emergency. They should reduce recurrence of hemorrhages, but nevertheless have no influence on the prognostic parameters which are essentially clinical.
Chenoufi Bahri
B
B
Service de Chirurgie Générale, CHU Mongi Slim, Sidi Daoud, Tunisie.
Larabi
B
B
Ayadi
S
S
D002986:Clinical Trials as Topic; D004837:Epinephrine / Q000627:therapeutic use; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D009829:Oleic Acids / Q000627:therapeutic use; D010438:Peptic Ulcer Hemorrhage / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D012720:Severity of Illness Index; D015996:Survival Rate; D013917:Thrombin / Q000627:therapeutic use; D016896:Treatment Outcome
D009829:Oleic Acids; D012597:Sclerosing Solutions; D013917:Thrombin; C033343:ethanolamine oleate; D004837:Epinephrine
Hémostase endoscopique des ulcères gastroduodénaux hémorragiques.