Injection Therapy for Nonvariceal Gastrointestinal Bleeding
Gastrointestinal hemorrhage is a common and serious problem - its average mortality of 10% has changed little over the past 40 years. In 80% of patients the bleeding stops spontaneously. In patients with continuous or recurrent bleeding (20%), mortality and morbidity are high, and emergency surgery...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
1990-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/1990/120392 |
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| Summary: | Gastrointestinal hemorrhage is a common and serious problem -
its average mortality of 10% has changed little over the past 40 years. In 80% of
patients the bleeding stops spontaneously. In patients with continuous or recurrent
bleeding (20%), mortality and morbidity are high, and emergency surgery
is often required, which has a higher mortality than the same operation performed
electively. Successful therapeutic endoscopic intervention in this high risk group
is necessary to improve outcome. For injection treatment of nonvariceal bleeding
lesions, the author has been using the Soehendra method (1:10,000 adrenaline
and polidocanol) with success in 90% of actively bleeding patients. Three
controlled trials of endoscopic sclerosis in bleeding peptic ulcer disease showed
decreased blood transfusions, surgery and hospital stay, but did not find any
significant difference in mortality. The ideal solution and the usefulness of
additional therapy are questions which must be addressed via prospective controlled
trials of a large number of patients. |
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| ISSN: | 0835-7900 |