2000 Volume 56 Issue 2 Pages 50-51
From April 1992 to July 1998, 133 patients with upper gastrointestinal bleeding were treated by endoscopic hemostasis. These 133 included 119 cases of gastroduodenal ulcer, 6 of Mallory-Weiss syndrome, 2 of gastric cancer and 6 of gastric vascular ectasia. We carried out hemostasis by injection of pure ethanol or hypertonic saline-epinephrine (HSE) , or hemoclipping for the cases of gastroduodenal ulcer, Mallory-Weiss syndrome and gastric cancer. For those of gastric vascular ectasia, we also did it by injection of pure ethanol and electrocoagulation, or endoscopic ligation using O-ring. Of the 119 cases of gastroduodenal ulcer bleeding, 3 were finally treated by TAE due to difficulty of endoscopic hemostasis and another 3 died of cardiovascular disorders after treatment. Of the 38 who underwent hemostasis by injection of pure ethanol 13 had enlargement of ulcer, but not the episode of re-bleeding. Enlargement of ulcer after injection of pure ethanol was significantly correlated with amount of ethanol. One of the 10 cases treated by injection of HSE had rupture of esophagus. One of the 3 cases treated by ligation had re-bleeding because of slipping out of O-ring. It is important to make sure of limitation for indicating endoscopic hemostasis and to make care of complication.
