title: A prospective, randomized trial of endoscopic band ligation vs. epinephrine injection for actively bleeding Mallory-Weiss syndrome.
abstract: BACKGROUND
  Effective hemostatic treatment is mandatory for patients with actively bleeding Mallory-Weiss syndrome. This study evaluated the respective efficacy and the safety of endoscopic band ligation and endoscopic epinephrine injection in Mallory-Weiss syndrome.
  
  
  METHODS
  Thirty-four consecutive patients with actively bleeding Mallory-Weiss syndrome were prospectively enrolled and were randomly assigned to undergo endoscopic band ligation or endoscopic injections of a 1:10,000 solution of epinephrine. Demographic characteristics, endoscopic variables, and outcome parameters, including rates of hemostasis and recurrent bleeding, were analyzed.
  
  
  RESULTS
  The number of elastic bands applied was one or two; the mean volume of epinephrine injected was 18.0 mL: 95% CI[16.8, 19.2]. There was no significant difference between the groups with respect to age, gender, alcohol ingestion, presenting symptoms, Hb level, shock, comorbid diseases, coagulopathy, tear location, blood transfusion, or duration of hospitalization. Primary hemostasis was achieved in all 17 patients in the band ligation group and in 16 of 17 patients (94.1%) in the epinephrine injection group. There was no recurrence of bleeding or major complication in either group.
  
  
  CONCLUSIONS
  In this small study, no difference was detected in the efficacy or the safety of band ligation vs. epinephrine injection for the treatment of actively bleeding Mallory-Weiss syndrome.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Sang-Woon
authors.initials: SW
authors.lastname: Min
authors.forename: Young-Hae
authors.initials: YH
authors.lastname: Sohn
authors.forename: Wan-Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew
authors.forename: Sei-Jong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D016099:Endoscopy, Gastrointestinal; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008026:Ligation; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine