Endoscopic injection of alcohol to stop peptic ulcer hemorrhage. Experience with 115 cases

In a period of 33 months, we performed endoscopic injection with pure alcohol (PA) to try to stop peptic ulcer hemorrhage in 115 patients. The sex ratio (M/F) was 104/11. The average age was 59.5 +/- 1.5 years (mean +/- SEM). Sixty-two patients (53.9%) were in shock before endoscopic injection. Thirty-three (28.7%) had spurting hemorrhage, 31 (27%) oozing hemorrhage, and 51 (44.3%) nonbleeding visible vessels (NBVV). We obtained initial success in 92 patients (80%). Rebleeding episodes occurred in 7 patients (7.6%) within 7 days of endoscopic injection. Five of those who rebled received a second injection with PA and bleeding stopped in three of them. In 88 (76.5%) patients, therapy was ultimately successful. The duration of hospitalization was 5.1 +/- 0.6 days (mean +/- SEM). The total volume of blood transfused was 1450 +/- 192 ml (mean +/- SEM). We conclude that endoscopic injection is an inexpensive, convenient, and effective means for arresting peptic ulcer hemorrhage. It can be used as the first therapeutic approach.