Endoscopic adrenaline injection in treatment of bleeding peptic ulcers

This study aimed to compare the results of bleeding peptic ulcer treated by endoscopic adrenaline injection with controls treated conventionally. Between January 1991 and December 1993, 69 patients with actively bleeding peptic ulcers with visible vessel received endoscopic adrenaline injection. This group of patients was compared with 31 endoscopically similar patients treated conventionally, using H2 blockers with or without surgery, from October 1987 to December 1990 prior to the introduction of endoscopic injection therapy in this hospital. Both groups of patients were comparable in terms of age, haemoglobin level on admission and site of ulcer (gastric or duodenal). Permanent haemostasis was attained with endoscopic adrenaline injection in 97% of our patients. Rebleeding occurred in 9% in the injected group vs 39% in the historical control group (p < 0.005). Three percent of patients in the injected group had emergency surgery compared with 48% in the control group (p < 0.005). The median hospital stay and transfusion requirements in the injected group were 6 days and 2 units respectively vs 8 days and 3 units in the control group but the difference was not statistically significant. We conclude that endoscopic adrenaline injection is effective in the treatment of bleeding peptic ulcer leading to a reduction in rebleeding rate and emergency surgery.