scholarly journals Transcatheter Arterial Embolisation of Acute Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Haemostasis

2020 ◽  
Vol 23 (3) ◽  
pp. 164-175
Author(s):  
JH Kwon ◽  
JS Kim
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Endoscopic Haemostasis ◽  
Transcatheter Arterial Embolisation ◽  
Arterial Embolisation ◽  
Upper Gastrointestinal

scholarly journals Variation in exposure to endoscopic haemostasis for acute upper gastrointestinal bleeding during UK gastroenterology training

2019 ◽  
Vol 11 (6) ◽  
pp. 436-440 ◽  
Author(s):  
Keith Siau ◽  
A John Morris ◽  
Aravinth Murugananthan ◽  
Brian McKaig ◽  
Paul Dunckley
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Training System ◽  
Advisory Group ◽  
Endoscopic Haemostasis ◽  
Endoscopy Training ◽  
Acute Upper Gastrointestinal Bleeding ◽  
The Uk ◽  
Upper Gastrointestinal ◽  
Adrenaline Injection

IntroductionGastroenterologists are typically expected to be competent in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB), with the Certificate of Completion of Training (CCT) often heralding the onset of participation in on-call AUGIB rotas. We analysed the volume of haemostasis experience recorded by gastroenterology CCT holders on the Joint Advisory Group on Gastrointestinal Endoscopy Training System (JETS) e-portfolio, the UK electronic portfolio for endoscopy, and assessed for variations in exposure to haemostasis.MethodsUK gastroenterologists awarded CCT between April 2014 and April 2017 were retrospectively identified from the specialist register. Credentials were cross-referenced with JETS to retrieve AUGIB haemostasis procedures prior to CCT. Procedures were collated according to variceal versus non-variceal therapies and compared across training deaneries.ResultsOver the 3-year study period, 241 gastroenterologists were awarded CCT. 232 JETS e-portfolio users were included for analysis. In total, 12 932 haemostasis procedures were recorded, corresponding to a median of 42 (IQR 21–71) per gastroenterologist. Exposure to non-variceal modalities (median 28, IQR 15–52) was more frequent than variceal therapies (median 11, IQR 5–22; p<0.001). By procedure, adrenaline injection (median 12, IQR 6–23) and variceal band ligation (median 10, IQR 5–20) were most commonly recorded, whereas sclerotherapy experience was rare (median 0, IQR 0–1). Exposure to haemostasis did not differ by year of CCT (p=0.130) but varied significantly by deanery (p<0.001), with median procedures ranging from 20–126.ConclusionExposure to AUGIB haemostasis during UK gastroenterology training varied across deaneries and procedural modalities which should prompt urgent locoregional review of access and delivery of training. Endoscopy departments should ensure the availability of supportive provisions in haemostasis (i.e. training/upskilling, supervision, mentorship) during the early post-CCT period.

scholarly journals Endoscopic haemostasis of bleeding duodenal ulcer

2007 ◽  
Vol 54 (1) ◽  
pp. 145-150 ◽  
Author(s):  
D. Popovic ◽  
V. Stankovic-Popovic ◽  
I. Jovanovic ◽  
M.N. Krstic ◽  
S. Djuranovic ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Endoscopy ◽  
Severe Bleeding ◽  
Endoscopic Injection ◽  
Endoscopic Haemostasis ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Bleeding Duodenal Ulcer ◽  
Upper Gastrointestinal

Introduction: Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. It manifests like: haematemesis, melaena or haemochezia. Diagnostic endoscopy accurately defining the cause of hemorrhage, while therapeutic endoscopy improves prognosis in patients who present with severe bleeding. Endoscopic therapies can be classified as those based on injection, application of heat, or mechanical clips. Patients and methods: This investigation was conducted in Department of endoscopic haemostasis, Clinic for gastroenterology and hepatology, CCS, using retrospective analysis of patients with acute upper gastrointestinal bleeding during the last five years. The aim of this study was to establish the number of upper gastrointestinal bleeding in our hospital during the last five years, and distribution of income according to type, difficulty, cause factors and risk factors of gastrointestinal bleeding and method of haemostasis. Results: In Department of endoscopic haemostasis 3954 patients with upper gastrointestinal bleeding were endoscoped, and 33,4% of them had bleeding duodenal ulcer. Male patients were statistically significant more present than female patients in group with duodenal ulcer ( 71,8%: 28,2%). 79.7% patients with duodenal ulcer had only haematemesis, while 14,4% patients had haematemesis and melaena. 59,1% patients with bleeding duodenal ulcer consumed salicylates and/or non-steroidal anti-inflammatory drugs ( NSAIDS) ( statistical significant differences ?2 test; p=0.007). Only endoscopic injection was used: in 36.8% of patients used injection of adrenaline solutions, while in 5,9% of patients used injection of adrenaline and absolute alcohol solutions. Conclusion: Using of therapeutic endoscopy improves better prognosis in patients who present with severe acute upper gastrointestinal bleeding. Endoscopist?s experience is an important independent prognostic factor for acute upper gastrointestinal bleeding.

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