Endoscopic hemostasis with metallic hemoclips for iatrogenic Mallory-Weiss tear caused by endoscopic examination.
OBJECTIVE
Applied endoscopic techniques including mucosal resection, sclerotherapy and endoscopic retrograde cholangiopancreatography (ERCP) have been advanced and iatrogenic complications including Mallory-Weiss tear (MWT) occasionally occur in daily endoscopic procedures. The present study aimed to examine the advantages of clipping for MWT complications that occur during endoscopic examination.


METHODS
Over 10 years, we experienced 47 patients with bleeding caused by MWT. Metallic hemoclips were applied for 38 patients for hemostasis. These patients were categorized into two groups: 18 patients in group A whose bleeding tear occurred during endoscopic examination in an iatrogenic condition, and 20 patients in group B visited the emergency unit due to other etiology of MWT.


RESULTS
The background characteristics, including length of tears, were not different between the two groups. Initial hemostasis was 100% in groups A and B. Rebleeding was 0/18 (0%) in group A and 1/20 (5 %) in group B. Number of patients who received blood transfusion was significantly higher in group B (group A: 0/18, group B: 4/20). Hemoglobin level before hemostasis was 12.5 g/dL in group A which was not different to that in group B, 10.9 g/dL.


CONCLUSIONS
Application of hemoclips was effective for bleeding MWT during endoscopic procedures, which warranted prophylactic application of hemoclips on MWT during endoscopic examination.
Shimoda
Ryo
R
Department of Internal Medicine, Saga Medical School, Saga, Japan.
Iwakiri
Ryuichi
R
Sakata
Hiroyuki
H
Ogata
Shinichi
S
Ootani
Hibiki
H
Sakata
Yasuhisa
Y
Fujise
Takehiro
T
Yamaguchi
Kanako
K
Mannen
Kotaro
K
Arima
Seichiro
S
Shiraishi
Ryosuke
R
Noda
Takahiro
T
Ono
Akihiro
A
Tsunada
Seiji
S
Fujimoto
Kazuma
K
D000368:Aged; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006488:Hemostasis, Surgical; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome