Endoscopic treatment of upper GI hemorrhage with a novel irrigating hood attached to the endoscope.
BACKGROUND
Despite advances in endoscopic treatment methods for upper GI hemorrhage, hemostasis is often difficult to achieve, particularly when the endoscopic view at the site of hemorrhage is poor because of the presence of mucus and blood. The investigators developed an end hood that facilitates endoscopic hemostatic procedures while simultaneously allowing irrigation of the bleeding site. The usefulness of this end hood for treatment of upper GI hemorrhage, excluding hemorrhage from varices, was evaluated.


METHODS
The end-hood piece was fabricated by drilling a side hole in the cap portion of a conventional transparent hood. An irrigation tube then was glued to the exterior surface of the hole. The fabricated transparent hood was placed on the tip of an endoscope. With the hood piece in place, hemoclip placement and other endoscopic hemostatic procedures were performed in 15 patients with nonvariceal upper GI hemorrhage.


RESULTS
Hemostasis was successfully achieved in all cases. In all cases of active hemorrhage, hemostatic treatment was enhanced by simultaneous irrigation beneath the hood. The median time required for the hemostatic procedure with the attached hood was 4.8 minutes.


CONCLUSIONS
The end-hood irrigation device and technique facilitate endoscopic hemostatic treatment of nonvariceal upper GI hemorrhage.
Kume
Keiichiro
K
Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyusyu, Japan.
Yoshikawa
Ichiro
I
Otsuki
Makoto
M
D000368:Aged; D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D007507:Therapeutic Irrigation / Q000295:instrumentation*