Endoscopic Hemostasis of Nonvariceal Gastrointestinal Bleeding

Yoshihiro Inoue,Makoto Onodera,Masayuki Sato,Yasuhisa Fujino,Shigeatsu Endo,Satoshi Kikuchi,Masahiro Kojika,Hisaho Sato

doi:10.4236/ijcm.2014.519147

Yoshihiro Inoue, Makoto Onodera + Show 6 more

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https://doi.org/10.4236/ijcm.2014.519147

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Abstract

We investigated 2668 patients with non-variceal upper gastrointestinal bleeding and 660 patients with lower gastrointestinal bleeding treated between 1987 and 2011 in our hospital. Upper gastrointestinal bleeding was associated with gastric ulcer, duodenal ulcer, Mallory-Weiss syndrome, esophageal disease, and others. Endoscopic hemostasis was performed in approximately 67% of all cases with upper gastrointestinal bleeding and approximately 90% of cases with ulcer. The hemostasis success rate was over 90% for ulcer bleeding, and was also generally high for other diseases. The total number of patients with lower gastrointestinal bleeding was lower, with it being approximately 20% of those with upper gastrointestinal bleeding. Endoscopic hemostasis was performed in approximately 30% of the patients with lower gastrointestinal bleeding. The hemostasis success rate was generally high, but treatment switch to surgery or interventional radiology (IVR) was observed in some cases with colorectal diverticular bleeding.

Highlights

Endoscopic therapy has been the first line of treatment for upper gastrointestinal bleeding since the 1980s
Endoscopic hemostasis was performed in 1763 of 2625 patients (67.2%), excluding 43 patients with “other” diseases. These 1763 patients were composed of 1026 patients with gastric ulcer (90.6%); 432 patients with duodenal ulcer (89.4%); 118 patients with Mallory-Weiss syndrome (MWS) (41.4%); 60 patients with stomal ulcer (86.9%); 50 patients with iatrogenic disease (90.9%); 36 patients with malignant tumor (38.7%); 27 patients with esophageal disease, such as esophageal inflammation and esophageal ulcer (9.9%); and 14 patients with acute gastric mucosal lesion (AGML) (6.5%) (Table 3)
We reported the current state of endoscopic therapy for gastrointestinal bleeding in our hospital

Summary

Introduction

Endoscopic therapy has been the first line of treatment for upper gastrointestinal bleeding since the 1980s. Our hospital has adopted the endoscopic therapy since its establishment in November, 1980 up to the present. Endoscopic hemostasis of non-variceal upper gastrointestinal bleeding in our hospital used to be performed by local injections of hyper saline-epinephrine solution (HSE) [1] when we started. Microwave coagulation [2] was introduced in 1983, followed by adoption of heater probe coagulation (HP) [3] in 1986, which has been uti-. (2014) Endoscopic Hemostasis of Nonvariceal Gastrointestinal Bleeding. Endoscopic diagnosis and therapy for lower gastrointestinal bleeding are being actively performed in the recent times. We reviewed endoscopic hemostasis of upper and lower gastrointestinal bleeding performed in our hospital from 1987 to 2011, for approximately 25 years

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Conclusion