scholarly journals Endoscopic Injection Therapy in Bleeding Peptic Ulcers. Low Mortality in a High Risk Population

1992 ◽  
Vol 6 (5) ◽  
pp. 265-268 ◽  
Author(s):  
Joaqulm Balanzó ◽  
Candid Villanueva ◽  
Jorge C Espinós ◽  
Sergio Sáinz ◽  
German Soriano ◽  
...  
Keyword(s):  
High Risk ◽  
Injection Therapy ◽  
High Risk Population ◽  
Peptic Ulcers ◽  
Endoscopic Injection ◽  
Simple Method ◽  
Arterial Bleeding ◽  
Bleeding Peptic Ulcers ◽  
Initial Control ◽  
Bleeding Ulcers

Endoscoric injection therapy was performed in 341 patients consecutively admitted with a bleeding peptic ulcer at high risk of further hemorrhage, assessed by the presence of active arterial bleeding or a nonbleeding visible vessel at emergency endoscopy. Initial hemostasis was achieved in 111 of 119 actively bleeding patients (93%). Rebleeding ocurred in 75 cases (23%), at a mean interval of 53±52 h. A second emergency injection was a ttempted in 36 therapeutic failures, and was successful in 20 (55%). Emergency surgery was finally required in 52 patients (15%). Overall mortality was 4.9%. Major complications occurred in four patients (1.2%) (two perforations and two aspiration pneumonia); therefore, injection therapy is an effective and simple method for treating bleeding ulcers, achieving the initial control of hemorrhage in a majority of cases although the rate of further hemorrhage is not negligible and complications are not irrelevant.

scholarly journals Comparison of haemostatic efficacy for endoscopic injection therapy of epinephrine and combination therapy of epinephrine and hemoclips for bleeding peptic ulcers

2012 ◽  
Vol 140 (5-6) ◽  
pp. 299-304 ◽  
Author(s):  
Sasa Grgov ◽  
Perica Stamenkovic ◽  
Dejan Janjic
Keyword(s):  
Combination Therapy ◽  
Surgical Intervention ◽  
Randomized Study ◽  
Injection Therapy ◽  
Peptic Ulcers ◽  
Endoscopic Injection ◽  
Epinephrine Injection ◽  
Group I ◽  
Bleeding Peptic Ulcers ◽  
The Difference

Introduction. Endoscopic injection therapy of epinephrine is safe and effective in the treatment of bleeding peptic ulcer, but with high risk of rebleeding. The combination therapy of epinephrine and hemoclips could lead to a reduction of rebleeding and a potential reduction in mortality. Objective. To investigate the efficacy and safety of epinephrine injection therapy and combination therapy with epinephrine and hemoclips in treating bleeding peptic ulcers. Methods. A prospective randomized study included 58 patients with bleeding gastric or duodenal ulcer. In 30 patients endoscopic injection therapy with diluted epinephrine was applied (group I), while in 28 patients combination therapy of epinephrine and hemoclips was applied (group II). Results. Initial haemostasis was achieved in most patients treated with epinephrine injection therapy (93.3%) and patients treated with combination therapy of epinephrine and hemoclips (96.4%). After initial haemostasis was achieved rebleeding was significantly more frequent in the patients treated with epinephrine (28.5%) than in the patients treated with combination therapy (3.7%, p<0.05). Two patients treated with epinephrine injection therapy were subjected to surgical intervention, whereas no patient treated with combination therapy needed surgery. Lethal ending occurred in one patient treated with epinephrine and in one patient treated with combination therapy. The difference between the two groups of patients in need for surgical intervention and mortality was not statistically significant. Conclusion. Combination therapy with epinephrine and hemoclips is more efficient than epinephrine alone in the treatment of bleeding peptic ulcers.

scholarly journals Intramural hematoma: a rare complication of endoscopic injection therapy for bleeding peptic ulcers

Endoscopy ◽  
2011 ◽  
Vol 43 (S 02) ◽  
pp. E141-E142 ◽  
Author(s):  
A. Sadio ◽  
P. Peixoto ◽  
E. Cancela ◽  
A. Castanheira ◽  
V. Marques ◽  
...  
Keyword(s):  
Rare Complication ◽  
Intramural Hematoma ◽  
Injection Therapy ◽  
Peptic Ulcers ◽  
Endoscopic Injection ◽  
Bleeding Peptic Ulcers

Epinephrine alone vs epinephrine plus ethanol for injection therapy of bleeding peptic ulcers

1997 ◽  
Vol 45 (4) ◽  
pp. AB95 ◽  
Author(s):  
M.H. Lee ◽  
H.-Y. Jung ◽  
S.-K. Yang ◽  
H.R. Kim ◽  
W.-S. Hong ◽  
...  
Keyword(s):  
Injection Therapy ◽  
Peptic Ulcers ◽  
Bleeding Peptic Ulcers

Mo1310 OVER-THE-SCOPE CLIP AS FIRST-LINE THERAPY IN THE MANAGEMENT OF HIGH RISK BLEEDING PEPTIC-ULCERS: A CASE-MATCH CONTROL STUDY

2019 ◽  
Vol 89 (6) ◽  
pp. AB484
Author(s):  
Carlos Robles-Medranda ◽  
Juan M. Alcívar-Vásquez ◽  
Roberto Oleas ◽  
Jorge Baquerizo-Burgos ◽  
Juan I. Olmos ◽  
...  
Keyword(s):  
High Risk ◽  
Peptic Ulcers ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Bleeding Peptic Ulcers ◽  
Over The Scope Clip ◽  
Control Study

scholarly journals Adrenaline Injection Plus Argon Plasma Coagulation versus Adrenaline Injection Plus Hemoclips for Treating High-Risk Bleeding Peptic Ulcers: A Prospective, Randomized Trial

2009 ◽  
Vol 23 (10) ◽  
pp. 699-704 ◽  
Author(s):  
Seyed Alireza Taghavi ◽  
Seyed Mohammad Soleimani ◽  
Seyed Mohammad Kazem Hosseini-Asl ◽  
Ahad Eshraghian ◽  
Hajar Eghbali ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Prospective Randomized Trial ◽  
Peptic Ulcers ◽  
Plasma Coagulation ◽  
End Point ◽  
Bleeding Peptic Ulcers ◽  
Adrenaline Injection

BACKGROUND/OBJECTIVE: Several combination endoscopic therapies are currently in use. The present study aimed to compare argon plasma coagulation (APC) + adrenaline injection (AI) with hemoclips + AI for the treatment of high-risk bleeding peptic ulcers.METHODS: In a prospective randomized trial, 172 patients with major stigmata of peptic ulcer bleeding were randomly assigned to receive APC + AI (n=89) or hemoclips + AI (n=83). In the event of rebleeding, the initial modality was used again. Patients in whom treatment or retreatment was unsuccessful underwent emergency surgery. The primary end point of rebleeding rate and secondary end points of initial and definitive hemostasis need for surgery and mortality were compared between the two groups.RESULTS: The two groups were similar in all background variables. Definitive hemostasis was achieved in 85 of 89 (95.5%) of the APC + AI and 82 of 83 (98.8%) of the hemoclips + AI group (P=0.206). The mean volume of adrenaline injected in the two groups was equal (20.7 mL; P=0.996). There was no significant difference in terms of initial hemostasis (96.6% versus 98.8%; P=0.337), rate of rebleeding (11.2% versus 4.8%; P=0.124), need for surgery (4.5% versus 1.2%; P=0.266) and mortality (2.2% versus 1.2%; P=0.526). When compared for the combined end point of mortality plus rebleeding and the need for surgery, there was an advantage for the hemoclip group (6% versus 15.7%, P=0.042).CONCLUSION: Hemoclips + AI has no superiority over APC + AI in treating patients with high-risk bleeding peptic ulcers. Hemoclips + AI may be superior when a combination of all negative outcomes is considered.

Emergency endotherapy of bleeding peptic ulcers with high risk stigmata (HRS): Can different techniques affect the patients outcome?

2006 ◽  
Vol 38 ◽  
pp. S208-S209
Author(s):  
A. Garripoli ◽  
P. Martinoglio ◽  
A. Mondardini ◽  
P. Secreto ◽  
D. Turco ◽  
...  
Keyword(s):  
High Risk ◽  
Peptic Ulcers ◽  
Bleeding Peptic Ulcers

157 Early Angiographic Embolization After Endoscopic Hemostasis to High Risk Bleeding Peptic Ulcers Improves Outcomes

2014 ◽  
Vol 146 (5) ◽  
pp. S-44 ◽  
Author(s):  
James Y. Lau ◽  
Ka-tak Wong ◽  
Philip W. Chiu ◽  
Rapat Pittayanon ◽  
Rungsun Rerknimitr ◽  
...  
Keyword(s):  
High Risk ◽  
Endoscopic Hemostasis ◽  
Angiographic Embolization ◽  
Peptic Ulcers ◽  
Bleeding Peptic Ulcers
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