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: Paul Kortan
Format: Article
Language:English
Published: Wiley 1990-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/1990/120392
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author Paul Kortan
author_facet Paul Kortan
author_sort Paul Kortan
collection DOAJ
description 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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series Canadian Journal of Gastroenterology
spelling doaj-art-028e15790b2b485b8f7aef1921674cda2025-02-03T06:44:29ZengWileyCanadian Journal of Gastroenterology0835-79001990-01-014965065210.1155/1990/120392Injection Therapy for Nonvariceal Gastrointestinal BleedingPaul KortanGastrointestinal 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.http://dx.doi.org/10.1155/1990/120392
spellingShingle Paul Kortan
Injection Therapy for Nonvariceal Gastrointestinal Bleeding
Canadian Journal of Gastroenterology
title Injection Therapy for Nonvariceal Gastrointestinal Bleeding
title_full Injection Therapy for Nonvariceal Gastrointestinal Bleeding
title_fullStr Injection Therapy for Nonvariceal Gastrointestinal Bleeding
title_full_unstemmed Injection Therapy for Nonvariceal Gastrointestinal Bleeding
title_short Injection Therapy for Nonvariceal Gastrointestinal Bleeding
title_sort injection therapy for nonvariceal gastrointestinal bleeding
url http://dx.doi.org/10.1155/1990/120392
work_keys_str_mv AT paulkortan injectiontherapyfornonvaricealgastrointestinalbleeding