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Endoscopic Control of Gastroduodenal Hemorrhage

Endoscopic Control of Gastroduodenal Hemorrhage Several methods of endoscopically controlling acute, nonvariceal upper. gastrointestinal bleeding have been developed. Some, such as the laser, heater probe, and bipolar electrocoagulation, have been evaluated in con­ trolled clinical trials. The purpose of this paper is to discuss endoscopic control of nonvariceal gastroduodenal hemorrhage and to consider whether improvement in outcome is likely with any of these devices. Techniques and results of controlled clinical trials are reviewed. INTRODUCTION Acute upper gastrointestinal (GI) bleeding is a common and serious emerg­ ency. The mortality rate has remained at about 10% over the past 40 years, despite improvements in intensive care, blood product replacement, endoscopy, and surgical techniques. Some progress has occurred because mortality rates do not reflect the steady age increase of patients with GI bleeding-the average age is about 60 years, and about 25% of patients are over 75 years (1). A large American Society of Gastrointestinal Endoscopists (ASGE) survey on acute upper GI bleeding enumerated several patient charac­ teristics associated with this clinical condition (2). Duodenal or gastric ulcers accounted for 45% of cases. In the majority of patients, bleeding stopped, did not recur, and mortality was low. In about 25%, however, bleeding was continuous and mortality http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annual Review of Medicine Annual Reviews

Endoscopic Control of Gastroduodenal Hemorrhage

Kovacs, T O G; Jensen, D M
Annual Review of Medicine , Volume 38 (1) – Feb 1, 1987
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References (6)

Publisher
Annual Reviews
Copyright
Copyright 1987 Annual Reviews. All rights reserved
Subject
Review Articles
ISSN
0066-4219
eISSN
1545-326X
DOI
10.1146/annurev.me.38.020187.001411
pmid
3555295
Publisher site
See Article on Publisher Site

Abstract

Several methods of endoscopically controlling acute, nonvariceal upper. gastrointestinal bleeding have been developed. Some, such as the laser, heater probe, and bipolar electrocoagulation, have been evaluated in con­ trolled clinical trials. The purpose of this paper is to discuss endoscopic control of nonvariceal gastroduodenal hemorrhage and to consider whether improvement in outcome is likely with any of these devices. Techniques and results of controlled clinical trials are reviewed. INTRODUCTION Acute upper gastrointestinal (GI) bleeding is a common and serious emerg­ ency. The mortality rate has remained at about 10% over the past 40 years, despite improvements in intensive care, blood product replacement, endoscopy, and surgical techniques. Some progress has occurred because mortality rates do not reflect the steady age increase of patients with GI bleeding-the average age is about 60 years, and about 25% of patients are over 75 years (1). A large American Society of Gastrointestinal Endoscopists (ASGE) survey on acute upper GI bleeding enumerated several patient charac­ teristics associated with this clinical condition (2). Duodenal or gastric ulcers accounted for 45% of cases. In the majority of patients, bleeding stopped, did not recur, and mortality was low. In about 25%, however, bleeding was continuous and mortality

Journal

Annual Review of Medicine – Annual Reviews

Published: Feb 1, 1987

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