title: Endoscopic injection therapy of bleeding ulcer: a prospective and randomized comparison of adrenaline alone or with polidocanol.
abstract: In a prospective randomized trial involving 63 patients with bleeding peptic ulcer, we assessed whether the addition of 1% polidocanol improved the results achieved by 1/10(4) adrenaline alone for injection therapy. The inclusion criterion was the presence of active arterial bleeding or a nonbleeding visible vessel at emergency endoscopy. Thirty patients were treated with 1/10(4) adrenaline (group A) and 33 with adrenaline plus 1% polidocanol (group B). Initial hemostasis was achieved in 97% of cases in both groups and permanent hemostasis in 87% patients in group A and in 76% in group B (p = NS). Mortality was 6% in group A and 3% in group B. There were no differences between the two groups regarding requirements for emergency surgery, the number of transfusions, or the length of hospital stay. One patient in group B had a perforation. No other relevant complications were noted. In conclusion, combined therapy does not improve the results achieved with adrenaline alone.
authors.affiliation: Department of Gastroenterology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Villanueva
authors.forename: J
authors.initials: J
authors.lastname: Balanzó
authors.forename: J C
authors.initials: JC
authors.lastname: Espinós
authors.forename: E
authors.initials: E
authors.lastname: Fábrega
authors.forename: S
authors.initials: S
authors.lastname: Sáinz
authors.forename: D
authors.initials: D
authors.lastname: González
authors.forename: F
authors.initials: F
authors.lastname: Vilardell
mesh_terms: D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000628:therapy*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004837:Epinephrine