1997 Volume 50 Pages 254-255
A patient of 46-year-old male under hemodialysis owing to chronic renal failure (CRF) admitted to the hospital due to massive hematemesis and decreasing in blood pressure. An emergent endoscopy was carried out, and bleeding from a gastric elevated erosion in the antrum was found. By applying five times of clipping to the lesion, complete hemostasis was achieved.
Erosive lesions of the upper gastrointestinal tract occurred with CRF, are known to be refractory to medical treatment. According to our data, the hemorrhage from gastric elevated erosion in CRF patient was one of the major causes of gastrointestinal hemorrhage. Usually the gastric erosions were located in the antrum and the source of active hemorrhage from them was single. Moreover, that hemorrhage tended to occur in the patients with long-term hemodialysis. We concluded that when the hemorrhage from the gastric erosion is difficult to control only by medications, it is necessary to add an endoscopic hemostasis such as clipping which does not damage the gastric mucosa so much.
