The hemostatic effect of endoscopic sodium hyaluronate injection in peptic ulcer bleeding.
OBJECTIVE
Endoscopic injection therapy is a well-established method of controlling peptic ulcer bleeding but it is not clear which agent would be the best choice for injection material. In this study, we evaluated the effect of Sodium Hyaluronate for control of ulcer bleeding.


METHODS
The subjects consisted of 26 patients with major peptic ulcer hemorrhage from June 2000 to August 2001. There were 17 gastric ulcers, 7 duodenal ulcers and 2 ulcers at anastomosis site. According to modified Forrest classifications, there were 7 active bleeding (spurting, 3; oozing, 4) and 19 stigmata of recent hemorrhage (visible vessel, 14; fresh blood clots, 5). Sodium Hyaluronate-saline solution was injected to control the bleeding. The initial and permanent hemostatic rate, rebleeding rate, and other complications were retrospectively evaluated.


RESULTS
The initial hemostatic rate was 25/26 (96.2%) and re-bleeding rate 3/26 (11.5%). The success rate of the second trial of Sodium Hyaluronate injection was 3/3 (100%). Overall, the permanent hemostatic rate was 25/26 (96.2%) and there were no complications related to Sodium Hyaluronate injection.


CONCLUSIONS
Sodium Hyaluronate is an excellent candidate agent for endoscopic injection therapy because of its convenience and safety. Further prospective randomized trials with other hemostatic methods are needed.
Cho
Yong Kyun
YK
Department of Internal Medicine, Kangbuk Samsung Hospital Sungkyunkwan University, School of Medicine, Seoul, Korea. choyk2004.cho@samsung.com
Kim
Chang Seop
CS
Kim
Si Young
SY
Park
Jung Ho
JH
Kim
Hong Joo
HJ
Park
Dong Il
DI
Sohn
Chong H
CH
Jeon
Woo Kyu
WK
Kim
Byung Ik
BI
Shin
Jun Ho
JH
Son
Byung Ho
BH
D000328:Adult; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007267:Injections; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D016896:Treatment Outcome
D006490:Hemostatics; D006820:Hyaluronic Acid