Bleeding peptic ulcer: experience with endoscopic therapy

Area of Science:

• Gastroenterology
• Endoscopic Hemostasis
• Peptic Ulcer Disease Management

Background:

• Peptic ulcer bleeding is a severe complication with high mortality.
• Traditional early surgery for bleeding ulcers carries significant risks in elderly patients.

Purpose of the Study:

• To evaluate the effectiveness of endoscopic adrenaline injection therapy for bleeding peptic ulcers.
• To compare endoscopic therapy outcomes with surgical intervention.

Main Methods:

• Endoscopic diagnosis and adrenaline injection therapy were performed on 196 patients with bleeding peptic ulcers.
• 130 patients had active or recent bleeding, with 53 receiving adrenaline for active bleeding and 77 for recent bleeds.

Main Results:

• Endoscopic adrenaline injection achieved hemostasis in 97.7% of patients.
• Re-bleeding occurred in 20.5% of patients; repeat endoscopic therapy was successful in 19 of 26 cases, with 7 requiring surgery.
• Three deaths occurred, primarily due to advanced age and comorbidities.

Conclusions:

• Endoscopic adrenaline injection is a simple, safe, and effective treatment for bleeding peptic ulcers.
• Repeat endoscopic therapy is a preferred alternative to surgery for re-bleeding.
• Surgery is indicated only for bleeding refractory or inaccessible to endoscopic control.