[Combined injection/endoscopic sclerotherapy of upper gastrointestinal peptic ulcer hemorrhage]. 1997

J Kersák, and E Varga, and T Beró
Siófok Város Kórház-Rendelöintézete, Belgyógyászati Osztály.

In the last 8 years period 369 patients with acute upper gastrointestinal bleeding were admitted to the Department of Internal Medicine, District Hospital Siófok. All patients were treated by combined injection sclerotherapy during the urgent endoscopy. The sclerotizing solution contained at the first step ethamsylate, calcium gluconate, epinephrin, hypertonic saline solution, and the second step 1% aethoxysklerol. At he time of urgent endoscopy 77% of the patients had acute bleeding (Forrest I.a., I.b.) and 23% of them showed stigmata of fresh bleeding (Forrest II.a., II.b.). Primary endoscopic hemostasis was achieved in all patients. In 7.9% of patients (n = 29) developed recurrent bleeding during the observation period, who were resclerotized. Twenty of them (5.4%) were treated by elective surgery. No hemorrhagic or sclerotizing therapy associated mortality occurred. Five out of 20 operated patients (1.4% of all sclerotized cases) had died due to the serious complications of their chronic liver disease. Patients with succesful initial endoscopic hemostasis were treated conservatively (proton pump inhibitors, H-2 blockers, antacids, sucralfate, lactulose) and underwent control endoscopy after 24 hours. Using this sclerotizing method in the treatment of acute upper gastrointestinal bleedings the number of acute surgery and mortality decreased significantly. It is supposed, that the locally administered ethamsylate, calcium gluconate, epinephrin, hypertonic saline solution and aethoxysklerol containing sklerotizing solution might play a favorable role in the successful control of acute bleeding ulcers.

UI MeSH Term Description Entries
D007267 Injections Introduction of substances into the body using a needle and syringe. Injectables,Injectable,Injection
D007388 Internal Medicine A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010438 Peptic Ulcer Hemorrhage Bleeding from a PEPTIC ULCER that can be located in any segment of the GASTROINTESTINAL TRACT. Hemorrhage, Peptic Ulcer,Peptic Ulcer Hemorrhages,Ulcer Hemorrhage, Peptic
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005260 Female Females
D006487 Hemostasis The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION. Hemostases
D006748 Hospital Departments Major administrative divisions of the hospital. Departments, Hospital,Department, Hospital,Hospital Department

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