Tranexamic acid in gastric and duodenal bleeding

In this prospective, randomized, double-blind study the effect of the antifibrinolytic drug tranexamic acid was compared with that of placebo in 154 patients bleeding from verified benign lesions in the stomach and/or duodenum. Three out of 72 patients receiving tranexamic acid underwent emergency surgery, in contrast to 15 out of 82 in the placebo group (p = 0.010). Nineteen patients receiving placebo rebled during admission, as compared with 10 in the treatment group (p = 0.097). The blood transfusion requirement was significantly reduced by tranexamic acid (p = 0.018). Side effects were seen in six patients, of which an uncomplicated deep venous thrombosis was the most severe. It was concluded that tranexamic acid reduces the blood transfusion requirement and the need for emergency surgery in patients bleeding from a benign gastric or duodenal lesion.