Endoscopic Treatment of Upper Gastrointestinal Bleeding. 2005

Aric J Hui, and Joseph J Y Sung
Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, N. T., Hong Kong SAR, China. joesung@cuhk.edu.hk.

Endoscopic therapy for nonvariceal bleeding should only be used if major stigmata of hemorrhage such as active bleeding and nonbleeding visible vessel are present. Treatment of peptic ulcers with adherent clots is currently controversial. Combination of epinephrine injection and coaptive coagulation is most effective in achieving endoscopic hemostasis. Hemoclips may be preferable for very deep ulcers and large visible blood vessels if coaptive coagulation is anticipated to have a high risk of perforation or bleeding. Adrenaline injection or hemoclip application should be used in bleeding Mallory-Weiss tears, as the safety of thermal methods is not well established. Argon plasma coagulation is the mainstay of endoscopic treatment for superficial lesions such as angiodysplasia and gastric antral vascular ectasia. Both sclerotherapy and band ligation are effective in acute hemostasis of bleeding esophageal varices. Variceal band ligation is preferred due to its superior safety profile and shorter procedure time. Due to the early recurrence of varices after banding ligation, there may be a role for metachronous combination therapy of ligation followed by sclerotherapy. Histoacryl glue is the preferred method of endoscopic hemostasis in gastric varices.

UI MeSH Term Description Entries

Related Publications

Aric J Hui, and Joseph J Y Sung
June 1980, Journal of clinical gastroenterology,
Aric J Hui, and Joseph J Y Sung
April 2002, Minerva medica,
Aric J Hui, and Joseph J Y Sung
December 1989, The Surgical clinics of North America,
Aric J Hui, and Joseph J Y Sung
September 1987, Endoscopy,
Aric J Hui, and Joseph J Y Sung
January 1990, Journal of clinical gastroenterology,
Aric J Hui, and Joseph J Y Sung
July 1985, Canadian journal of surgery. Journal canadien de chirurgie,
Aric J Hui, and Joseph J Y Sung
May 2022, Clinical endoscopy,
Aric J Hui, and Joseph J Y Sung
January 1989, Journal of gastroenterology and hepatology,
Aric J Hui, and Joseph J Y Sung
February 2006, The American surgeon,
Aric J Hui, and Joseph J Y Sung
February 2004, Best practice & research. Clinical gastroenterology,
Copied contents to your clipboard!