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Endoscopic electrohemostasis of active upper gastrointestinal bleeding
Insights
Emergency upper gastrointestinal bleeding can be effectively controlled using endoscopic electrocautery. This safe and rapid technique achieved permanent hemostasis in 92% of patients after one treatment, minimizing the need for surgery.
Area of Science:
- Gastroenterology
- Endoscopic interventions
- Hemostasis techniques
Background:
- Active upper gastrointestinal bleeding necessitates prompt and effective intervention.
- Esophagogastroduodenoscopy is a primary diagnostic and therapeutic tool for upper GI bleeding.
- Endoscopic electrocautery offers a potential method for achieving hemostasis.
Observation:
- A clinical trial involved 160 patients undergoing emergency esophagogastroduodenoscopy for active upper GI bleeding.
- Endoscopic electrocautery was applied to 71 patients with identified bleeding points, excluding esophageal varices.
- Patients experienced significant pre-endoscopic blood loss, ranging from 1,500 to 6,000 ml.
Findings:
- Initial hemostasis was achieved in all 71 patients treated with endoscopic electrocautery.
- Permanent hemostasis was obtained in 92% of patients after a single treatment.
- Only two patients required emergency surgery, and no complications were reported.
Implications:
- Endoscopic electrocautery demonstrates significant safety and efficacy in controlling active upper gastrointestinal bleeding.
- The technique is rapid and potentially reduces the need for surgical intervention.
- Further research is recommended before widespread clinical adoption, but it shows promise as a widely available medical community tool.
Abstract:
Emergency esophagogastroduodenoscopy for active upper gastrointestinal bleeding was performed in 160 patients. Endoscopic electrocautery for control of bleeding was considered in the last ninety patients and performed in seventy-one patients. All lesions except esophageal varices were candidates for electrohemostasis. The indications for endoscopic electrocautery were active hemorrhage and precise identification of the bleeding point. The preendoscopic blood loss ranged from 1,500 to 6,000 ml. All seventy-one patients had initial hemostasis and sixty-five (92 per cent) had permanent hemostasis after one treatment. Six patients rebled, and four of these had permanent hemostasis after a second endoscopic electrocauterization. Only two of seventy-one patients had emergency operations for bleeding. There were no complications. Endoscopic electrohemostasis is still an experimental technic which requires further laboratory study and testing before broad general clinical application. This clinical trial suggests that endoscopic electrocautery is an attractive method of controlling active upper gastrointestinal bleeding because it can be safe, effective, and rapid, and is available in most medical communities.