Abstract
Objective: Endoscopic treatment is an effective and successful treatment for non-variceal upper gastrointestinal system (GIS) bleedings. In recent years, endoscopic combined therapies have been recommended for hemostasis. The aim of this study was to investigate primary hemostasis rates and re-bleeding rates obtained by epinephrine injection alone. Material and Methods: We analysed patients who had alone endoscopic epinephrine injection treatment for upper gastrointestinal system bleeding between January 2014 and January 2019. Gender, age, etiology of bleeding, Forrest classification, treatment efficacy and re-bleeding rates of the patients were recorded. The files of the patients were analyzed retrospectively. Results: The number of patients who met the study criteria was 107. There were 16 patients in Group 1 (Forrest 1a), 64 patients in Group 2 (Forrest 1b) and 27 patients in Group 3 (Forrest 2a). Primary hemostasis was achieved in 14 (87.5%) of 16 patients in Group 1, 62 (97%) of 64 in Group 2, and 27 (100%) of 27 Group 3. Re-bleeding rates were 4 (28%), 10 (16%), 2 (7%) in groups 1,2 and 3, respectively. Conclusion: It is thought that endoscopic combined treatment should be applied especially in patients with Forrest 1a and 1b bleeding ulcers, whereas in Forrest 2a ulcer patients, because of both the high rate of primary hemostasis and low rate of re-bleeding according to the results of the present study, the treatment of adrenalin injection alone can be used alone like other hemostasis modalities
Highlights
Upper gastrointestinal system bleeding has an incidence ranging from 48 to 160 cases per 100.000 people, depending on geographical regions
It is thought that endoscopic combined treatment should be applied especially in patients with Forrest 1a and 1b bleeding ulcers, whereas in Forrest 2a ulcer patients, because of both the high rate of primary hemostasis and low rate of re-bleeding according to the results of the present study, the treatment of adrenalin injection alone can be used alone like other hemostasis modalities
The present study aims to investigate the primary hemostasis success rates and re-bleeding rates of upper gastrointestinal system bleedings, which are stopped by epinephrine injection alone as an endoscopic treatment, according to the Forrest classification sub-groups
Summary
Upper gastrointestinal system bleeding has an incidence ranging from 48 to 160 cases per 100.000 people, depending on geographical regions. It is more common in men and in the elderly population. Different incidences between populations can be explained by various reasons such as drug-induced ulcers and the prevalence of Helicobacter Pylori [1, 2]. The peptic gastroduodenal ulcer is the most common cause of non-variceal upper gastrointestinal bleeding. Mortality due to upper gastrointestinal bleeding is associated with advanced age and accompanying comorbidities. The risk of mortality increases with recurrent bleeding [4]. Despite the use of therapeutic endoscopy and gastric acid suppressors for optimal treatment, it is seen that the mortality rate has remained constant between 6% and 14% in recent years [5]
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