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Injection or heat probe for bleeding ulcer.

S C Chung1, J W Leung, J Y Sung

  • 1Prince of Wales Hospital, Department of Medicine, Chinese University of Hong Kong.

Gastroenterology
|January 1, 1991
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Summary

Endoscopic epinephrine injection and heat probe treatment effectively control active peptic ulcer bleeding. Epinephrine injection offers a higher initial success rate and is technically simpler for managing bleeding ulcers.

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Area of Science:

  • Gastroenterology
  • Endoscopic interventions

Background:

  • Peptic ulcer bleeding is a significant cause of morbidity.
  • Endoscopic hemostasis is the primary treatment for active bleeding.

Purpose of the Study:

  • To compare the efficacy of endoscopic epinephrine injection versus heat probe treatment for active peptic ulcer bleeding.
  • To evaluate clinical outcomes including transfusion needs, emergency surgery, hospital stay, and mortality.

Main Methods:

  • Prospective randomized trial involving 132 patients with active ulcer bleeding.
  • Patients were randomized to receive either epinephrine injection or heat probe treatment.
  • Surgeons were blinded to the treatment allocation post-endoscopy.

Main Results:

  • Initial bleeding control was higher with epinephrine injection (96%) compared to heat probe (83%) (P<0.05).
  • No significant differences were observed in transfusion requirements, emergency surgery rates, hospital stay, or mortality.
  • Two perforations occurred in the heat probe group.

Conclusions:

  • Both endoscopic epinephrine injection and heat probe are effective for active peptic ulcer bleeding.
  • Epinephrine injection demonstrates a higher initial success rate and is technically easier.
  • Heat probe treatment carries a risk of perforation.