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[Non-surgical approach to bleeding gastric ulcer]
N S Mijalković1, S Djuranović, D Popović
1Institut za bolesti digestivnog sistema, Klinika za gastroenterologiju i hepatologiju, KCS, Beograd.
Acta Chirurgica Iugoslavica
|July 20, 2007
Summary
Bleeding gastric ulcers are common, often caused by NSAIDs. Endoscopic hemostasis is a safe and effective treatment, reducing the need for surgery.
Area of Science:
- Gastroenterology
- Endoscopy
- Emergency Medicine
Context:
- Bleeding gastric ulcers are a frequent cause for emergency upper endoscopy.
- Endoscopic hemostasis is a proven treatment for bleeding peptic ulcers.
Purpose:
- To analyze the frequency, etiological factors, and localization of bleeding gastric ulcers.
- To evaluate bleeding activity using Forrest's classification and assess endoscopic hemostasis modalities.
Summary:
- A retrospective review of 1230 patients with bleeding gastric ulcers (31.1% of 3954 endoscopies) revealed the antrum as the most common site (54.15%).
- NSAID/salicylate use was a primary etiological factor (54.6%), with melaena as the predominant symptom (82.44%). Most patients presented with Forrest grades IB and II (23.41% and 22.76%).
- Injection endoscopic hemostasis was performed in 26.34% of actively bleeding patients, achieving initial success in 96%.
Impact:
- Identifies NSAIDs/salicylates as key contributors to bleeding gastric ulcers.
- Demonstrates injection endoscopic hemostasis as a safe, cost-effective procedure with high success rates.
- Highlights the significance of endoscopic hemostasis in reducing emergency surgical interventions for bleeding gastric ulcers.
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