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Endoscopic injection therapy in bleeding Mallory-Weiss syndrome: a randomized controlled trial
J Llach1, J I Elizalde, M C Guevara
1Endoscopy Unit, Gastroenterology Department, Institut de Malalties Digestives, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, and Hospital Insular de Gran Canaria, Barcelona, Catalonia, Spain.
Gastrointestinal Endoscopy
|December 1, 2001
Summary
Endoscopic injection therapy significantly reduced recurrent bleeding in patients with Mallory-Weiss tears. This treatment also shortened hospital stays, offering a valuable option for managing this condition.
Area of Science:
- Gastroenterology
- Endoscopy
- Interventional Procedures
Background:
- Mallory-Weiss tears are a common cause of upper gastrointestinal bleeding.
- Endoscopic injection therapy is established for bleeding ulcers but its efficacy for Mallory-Weiss tears is less clear.
Purpose of the Study:
- To evaluate the effectiveness of endoscopic injection therapy in managing bleeding Mallory-Weiss tears.
- To compare outcomes between patients receiving endoscopic injection and those receiving no endoscopic therapy.
Main Methods:
- A randomized controlled trial was conducted with 63 patients suspected of having a Mallory-Weiss tear.
- Patients were assigned to either endoscopic injection therapy (epinephrine and polidocanol) or no endoscopic therapy.
- Outcomes assessed included recurrent bleeding, transfusion needs, complications, mortality, and hospital stay.
Main Results:
- Recurrent bleeding occurred in 6.2% of the endoscopic treatment group versus 25.8% in the control group (p < 0.05).
- Hospital stay was significantly shorter for the endoscopic treatment group (3.4 days vs. 5.5 days; p < 0.001).
- A trend towards lower transfusion requirements was observed in the treated group (p = 0.09); no complications were reported.
Conclusions:
- Endoscopic injection therapy is an effective management option for Mallory-Weiss syndrome.
- This therapy is particularly beneficial for patients at high risk of recurrent bleeding.