Abstract
For the purpose of arresting hemorrhage from the upper digestive tract, endoscopic local injection of hypertonic saline epinephrine (HS-E) solution has been performed at our hospital since October 1978. During emergency endoscopy, a total of 47 cases underwent local injection of HS-E solution under endoscopic procedure. Among fourty-seven cases were included gastric ulcer (28), stomal ulcer (6), duodenal ulcer (4), post-operative gpstric bleeding (4), gastric cancer (3) and Mallory-Weiss syndrome (2). Serious systemic complications were observed in approximately 60% of fourty-seven cases. Amount of blood transfusion required and the hematocrit value at time of bleeding showed a significant negative correlation, thus enabling estimation of necessary amount of blood transfusion from the hematocrit value at time of bleeding. Types of bleeding were classified as frterial, oozing and blood coagula forming. According to our criteria for the assessment of hemostatic effect, permanent and temporary arrest of hemorrhage were demonstrated in 85.1% and 10.6%, respectively. No apparent hemostatic effect was seen in only 4.3%. In order to prevent re-bleeding after initial arrest of hemorrhage in emergency, we have been employing prophylactic local injection of HS-E solution, which has hitherto been quite helpful. From the standpoint of simple maneuver and reasonable cost, endoscopic local injection of HS-E solution for arresting hemorrhage from the upper digestive tract seems to be an effective therapeutic method.
