Site and size of bleeding peptic ulcer. Is there any relation to the efficacy of hemostatic sclerotherapy?

Endoscopy. 1991 Mar;23(2):73-5. doi: 10.1055/s-2007-1010616.

Abstract

In 78 patients with high-risk bleeding peptic ulcers (either with active bleeding or non-bleeding visible vessel) endoscopic hemostasis by injection of adrenaline and polidocanol was attempted. Sclerotherapy was performed in 70 (90%) patients. Initial hemostasis was achieved in 35 (94.5%) patients with active bleeding, and permanent hemostasis in 61 (87%). Efficacy of injection therapy was significantly lower in ulcers larger than 2 cm (p = 0.001), and in those located on the posteroinferior duodenal wall (p = 0.03). It was not possible to perform endoscopic injection in 8 (10%) patients due to difficulty of access, lesions located mainly high on the lesser gastric curvature and on the posteroinferior duodenal wall. From these results we conclude that endoscopic injection is a very useful technique for the initial treatment of high-risk bleeding peptic ulcer, although the size and anatomical location of the lesions may be a limitation of its use.

MeSH terms

  • Aged
  • Duodenal Ulcer / complications*
  • Duodenal Ulcer / pathology
  • Duodenum / pathology
  • Endoscopy, Gastrointestinal
  • Epinephrine / therapeutic use*
  • Female
  • Hemostatic Techniques
  • Humans
  • Male
  • Peptic Ulcer Hemorrhage / therapy*
  • Polidocanol
  • Polyethylene Glycols / therapeutic use*
  • Sclerosing Solutions / therapeutic use*
  • Sclerotherapy*
  • Stomach / pathology
  • Stomach Ulcer / complications*
  • Stomach Ulcer / pathology

Substances

  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols
  • Epinephrine