EFFICACY OF EMERGENCY ENDOSCOPY AND ENDOSCOPIC PURE ETHANOL INJECTION HEMOSTASIS FOR UPPER G-I BLEEDING IN PATIENTS WITH HEMATOLOGICAL DISORDERS

Abstract

Efficacy of emergency endoscopy and endoscopic pure ethanol injection hemostasis for upper G-I bleeding in patients with hematological disorders was analysed retrospectively. Twenty-four patients with hematological disorders had emergency endoscopy in our endoscopy clinic during 7 and a half years from June 1979 to December 1986 because of upper G-I bleeding. They were 6 patients with acute leukemia, 9 patients with chronic myelogenous leukemia (CML), 3 patients with multiple myeloma, 2 patients with malignant lymphoma, 2 patients with hemophilia, l patient with von-Willebrand disease and 1 patient with idiopathic thrombocytopenic purpura. Sex ratio was 3: 1, and their mean age was 51 years. Most common bleeding site was gastro-duodenal erosion in acute leukemia (5/6, 83.3%), and peptic ulcer in CML (6/9, 66.7%). Hemostasis with endoscopic pure ethnol injection was performed in 10 patients. Temporary hemostasis was obtained in all cases. Re-bleeding occurred in 5 patients (50%) and was higher in hematological disorders in non-hematological patients. Complete hemostasis was obtained in all cases with repeated hemostasic procedure. It is important to combine with supplement therapy. No complication was seen, such as bleeding and perforation. Platelet transfusion was required if necessary. Therefore, it was considered that emergency endoscopy and endo-scopic pure ethanol injection hemostasis were effective for upper G-I bleeding in the patient with hematological disorders.