Tissue solidification in coping with digestive tract bleeding: hemostatic effect of local injection of 99.5% ethanol

Tatsuka et al. reported a local injection of 95% ethanol as a new endoscopic treatment of gastric protuberant lesions. In this method, the present author discovered that 99.5% ethanol injection has an excellent hemostatic effect. The author injected 99.5% ethanol into the cut-end of the stalk of 7 massively hemorrhaged cases encountered while performing double snare polypectomy. In all cases, the hemorrhage stopped within 5 or 15 min. In 9 patients with hemorrhagic gastric or duodenal ulcer who were judged at emergency endoscopic examination as needing some hemostatic treatment, an injection of 99.5% ethanol into the bleeding site achieved a satisfactory hemostasis in all of them. Ethanol injection into the surrounding tissue close to the bleeding vessels, a few injecting sites selected usually at 1 to 2 mm away from the bleeding vessels, 0.1 to 0.2 ml a time, could instantly suppress even the pulsatile bleeding with no hazards. If this method is used carefully with endoscopic skill, this should become the first choice for the gastro-intestinal hemorrhage except varices.