[Severe gastroduodenal ulcer hemorrhage. Treatment with endoscopic injections of an epinephrine solution]

Eighty-three patients (more than one half of whom were at high surgical risk) presenting with haemorrhages from a gastric or duodenal ulcer were treated with endoscopic injections of an epinephrine-hypertonic saline mixture. The overall rate of definitive haemostasis was 83 p. 100. Depending on the degree of haemorrhagic activity, this rate was 64 p. 100 in pulsatile lesions, 90.5 p. 100 in oozing lesions, 85.7 p. 100 in cases with visible vessels and 81.2 p. 100 when signs of recent bleeding were present. There was no dangerous complication related to the technique. The overall survival rate was 67.5 p. 100 and 20 out of the 26 deaths were due to other causes than haemorrhages. On follow-up, 94.7 p. 100 of the ulcers healed under antisecretory treatment within the usual length of time. This simple, effective and inexpensive technique is suggested as initial treatment of gastric or duodenal haemorrhages in subjects at high surgical risk, especially since the haemorrhage has no influence on the course of the ulcer.