Endoscopic injection therapy for non-variceal upper gastrointestinal bleeding at Auckland Hospital.
OBJECTIVE
The aim of this study was to audit the efficacy of endoscopic injection therapy for non-variceal upper gastrointestinal (GI) bleeding at Auckland Hospital.


METHODS
The medical records of 183 patients who had undergone endoscopic injection of adrenaline for non-variceal upper GI bleeding at Auckland Hospital between November 1996 and May 1999 were reviewed.


RESULTS
Primary haemostasis was achieved in 177 (96.7%) patients and six (3.3%) patients had early surgery due to failure of injection therapy. The overall rate of rebleeding was 18.6%. The rate of rebleeding according to the stigmata seen at the time of endoscopy was 36.8% for patients showing spurting vessel; 24% for active ooze; 18.2% for visible vessel; and 3.2% for adherent clot. Active spurting vessels seen on endoscopy were associated with higher risk of repeat injection (p <0.01) and death (p <0.001). Sixteen (9%) patients had repeat injection. Haemostasis was achieved in all, and no deaths or surgical interventions were observed in this subgroup.


CONCLUSIONS
Endoscopic injection therapy is an effective, simple and cheap first-line therapy for non-variceal upper GI bleeding. The repeat injection also appears to be an effective treatment for patients rebleeding after the initial injection therapy.
Ogra
Ravinder
R
Auckland Hospital. Rogra@middlemore.co.nz
Lane
Mark
M
Wong
Phillip
P
Fraser
Alan
A
D000368:Aged; D004837:Epinephrine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D005773:Gastroscopy; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000627:therapeutic use
D014662:Vasoconstrictor Agents; D004837:Epinephrine