The effect of endoscopic injection therapy on the clinical outcome of patients with benign peptic ulcer bleeding.
BACKGROUND
Our aim was to investigate the effect of endoscopic injection therapy on the clinical outcome of patients with benign peptic ulcer bleeding.


METHODS
In this study 1203 patients admitted with peptic ulcer bleeding over a 5-year period (January 1987 to April 1991) before endoscopic therapy and 1028 patients admitted with peptic ulcer bleeding after introduction of endoscopic therapy (May 1991 to March 1996) were assessed. Endoscopic therapy was performed in all patients with active bleeding or non-bleeding visible vessels during emergency endoscopy with injection of adrenaline, 1:10,000 in 0.9% saline.


RESULTS
The introduction of injection therapy was associated with a reduction in transfusion requirements (from 5.1 +/- 2.6 to 3.4 +/- 1.8 units), hospitalization days (from 10.8 +/- 6.5 to 7.8 +/- 5.1 days), surgical interventions (from 50.6% to 23.6%), and mortality (from 12.9% to 4.6%) in patients with active bleeding or non-bleeding visible vessels (P < 0.05) but remained unchanged in the rest. Patients with gastric ulcer had a more pronounced reduction in emergency surgical haemostasis and mortality than patients with duodenal ulcer. There were no deaths or procedure-related complications.


CONCLUSIONS
Endoscopic injection therapy with adrenaline/saline is a simple, low-cost, and safe method that improves the clinical outcome and reduces the mortality in patients with peptic ulcer bleeding.
Thomopoulos
K C
KC
Dept. of Internal Medicine, University Hospital, Patras, Greece.
Nikolopoulou
V N
VN
Katsakoulis
E C
EC
Mimidis
K P
KP
Margaritis
V G
VG
Markou
S A
SA
Vagianos
C E
CE
D001803:Blood Transfusion; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000150:complications*; D004630:Emergencies; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D016558:Hemostasis, Endoscopic; D006488:Hemostasis, Surgical; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications*; D016896:Treatment Outcome
D004837:Epinephrine