Tranexamic acid in gastric and duodenal bleeding

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Medicine

Background:

• Upper gastrointestinal bleeding from benign gastric or duodenal lesions is a common clinical challenge.
• Effective management strategies are crucial to minimize complications such as emergency surgery and blood transfusions.

Purpose of the Study:

• To evaluate the efficacy of tranexamic acid compared to placebo in patients with active bleeding from benign gastric or duodenal lesions.
• To assess the impact of tranexamic acid on the need for emergency surgery, rebleeding rates, and blood transfusion requirements.

Main Methods:

• A prospective, randomized, double-blind, placebo-controlled study was conducted.
• 154 patients with verified benign upper gastrointestinal lesions and bleeding were enrolled.
• Patients received either tranexamic acid or a placebo.

Main Results:

• Emergency surgery was required in significantly fewer patients treated with tranexamic acid (3/72) compared to placebo (15/82) (p = 0.010).
• The blood transfusion requirement was significantly reduced in the tranexamic acid group (p = 0.018).
• While rebleeding was less frequent with tranexamic acid (10/72 vs 19/82), this difference was not statistically significant (p = 0.097).

Conclusions:

• Tranexamic acid is effective in reducing the need for emergency surgery in patients with benign gastric or duodenal bleeding.
• The drug significantly decreases blood transfusion requirements in this patient population.
• While not statistically significant, a trend towards reduced rebleeding was observed with tranexamic acid.