We analysed the therapeutic result of endoscopic hemostasis for 75 cases of bleeding gastric ulcer from January 1994 to May 1995. Ethanol infusion was tried 118 times, and HSE infusion or clipping were tried 21 times each. In all 75 cases, endoscopic hemostasis was successful for the first time, but in 5 cases rebleeding was noted and 3 cases underwent operative therapy. In most cases, ethanol infusion was effective, but in some cases with a large exposed vessel or spurting bleeding, it was difficult to stop bleeding only with ethanol infusion, and clipping or HSE infusion or other method was needed.
Recently we tried continuous ethanol infusion therapy for 8 of those difficult cases. In this method, we inject 5 to 10 ml of ethanol directly into the exposed vessel continuously and very slowly over 2 to 10 minutes, and the ethanol injected into the vessel is never washed out by bleeding. So the effect to make thrombus is remarkable, and the hemostasis was successful and rebleeding was not noted in all 8 cases. Huge ulcer formation were noted in those cases because of extensive intraarterial thrombosis, but the healing of such artificial ulcers were very rapid and no trouble was aroused by those ulcers.
In conclusion, continuous ethanol infusion therapy was thought to be effective therapeutic modality for bleeding gastric ulcer especially with large exposed vessel and spurting bleeding.
