Abstract
In order to evaluate the effect and limitation of endoscopic hemostatic treatments, 422 patients with hemorrhagic gastric and duodenal ulcers admitted to our hospital before (Jan. 1978-Jul. 1981) and after (Aug. 1981-Jun. 1984) adopting these treatments were studied. Endoscopic treatments including bipolar electrocoagulation, local injection of hypertonic saline epinephrine solution and local injection of pure ethanol were applied to 68 patients with arterial bleeding or with exposed vessels. 1) Severe hemorrhage was more frequent in those with exposed vessels than in those without exposed vessels (Figure 1, 2, 3). 2) In hemorrhagic gastric and duodenal ulcers with exposed vessels the effective rates of H2-receptor antagonist were 51.1% and 75.0%, respectively. Endoscopic treatments were effective in 91.5% and 100%, respectively (Figure 4). 3) In hemorrhagic gastric and duodenal ulcers without exposed vessels the effective rates of H2-receptor antagonist were 96.7% and 98.5%, respectively. 4) The rates of emergency operation decreased after adopting endoscopic treatments. In hemorrhagic gastric ulcer the rate of emergency operation significantly decreased from 23.7% to 3.7%. In hemorrhagic duodenal ulcer it decreased from 7.4% to 2.4% (Figure 5). 5) Endoscopic treatments were also applied to patients with critical complications who had no operative indication. The re-bleeding rate for these patients was higher than those without serious complications.
