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Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
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[Endoscopic and surgical treatment of acute bleeding gastroduodenal ulcers]
1I. chirurgická klinika Fakultní nemocnice s poliklinikou U sv. Anny v Brnĕ, Ceská republika.
Abstract:
One of the basic problems of the treatment of acute bleeding from gastroduodenal ulcers concerns the correct timing of individual therapeutic steps. From 1992 to 1990 the I. Surgical Clinic in Brno performed the total of 438 urgent gastrofibroduodenoscopies, the most frequent finding being bleeding from the lesions in the area of the duodenal bulb. Endoscopic stoppage of bleeding was successful in 87.7% of patients. Failures in stopping the bleeding occurred in 18 cases and lead to urgent surgical intervention. On the basis of gained experience we recommend the following algorhithm in patients with acute bleeding from gastroduodenal ulcers: urgent endoscopy-endoscopic stoppage of bleeding. Relapse of bleeding requires endoscopic control with a new attempt of endoscopic therapy, in the case of failure it is urgent to intervene surgically. (Tab. 4, Ref. 14.)
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