title: Endoscopic hemostatic treatment under irrigation for upper-GI hemorrhage: a comparison of one third and total circumference transparent end hoods.
abstract: BACKGROUND
  Endoscopic hemostasis for upper-GI hemorrhage often is difficult to achieve if the view of the bleeding lesion is poor because of the presence of mucus, blood, and clots. An end hood that facilitates endoscopic hemostatic procedures while simultaneously allowing irrigation of the bleeding site was designed by us. Based on this design, a one-third partial irrigating end hood was developed, and its usefulness for treatment of non-variceal hemorrhage was evaluated.
  
  
  METHODS
  The end hood was fabricated by drilling a side hole in the cap portion of a transparent end hood. An irrigation tube was glued to the exterior surface over the hole. A "total" (type 1) and a "one-third partial" (type 2) transparent end hood were fabricated. These differ with respect to the proportion of the endoscope circumference that is hooded by the device. The fabricated transparent end hood was placed on the tip of a standard endoscope. With the end hood in place, endoscopic hemostatic treatment under irrigation was performed in 35 patients (type 1 end hood, 18; type 2, 17) with non-variceal upper-GI hemorrhage.
  
  
  METHODS
  Hemostatic treatment was enhanced by simultaneous irrigation beneath the end hood, and hemostasis was successfully achieved in 34 of 35 cases. The time required to achieve hemostasis was significantly shorter in the type 2 group than the type 1 group (median 11.8 vs. 16.9 minutes; p < 0.05).
  
  
  CONCLUSIONS
  The end hood was extremely useful for endoscopic hemostatic treatment under irrigation. The "one-third partial" end hood is superior to the total end hood in terms of duration of time required to achieve hemostasis.
authors.affiliation: Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyusyu, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kume
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
mesh_terms: D000368:Aged; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D007507:Therapeutic Irrigation