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Endoscopic hemostasis with local injection of pure ethanol in patients with gallard dieulafoy ulcer

Endoscopic hemostasis with local injection of pure ethanol in patients with gallard dieulafoy ulcer

Gastroenterological Endoscopy 28(3): 554-561

Gallard-Dieulafoy ulcer, relatively rare, often causes intractable massive bleeding with exposed vessel involvement in spite of small mucosal defect. Surgery has been the only therapeutic treatment of this type of ulcer. We tried local injection of pure ethanol for hemostasis in 6 patients with Dieulafoy ulcers, and all patients were treated successfully. Six patients (47 .apprx. 66 y.o., 3 males and 3 females), were diagnosed to be Dieulafoy ulcer endoscopically. All patients had a small and shallow ulcer ranged from 4 to 10 mm in diameter with large diameter vessel exposed. Most of them had projectile or pulsating bleeding. Bleeding foci were located in the cardia in two patients, and in the lower body in four. Three patients had hematemesis and tarry stools and the other three had tarry stools only. Five of the 6 patients showed a shock symptom. Three of the patients had a co-existent disease and the other three had a history of mental stress, alcohol abuse, or taking analgesics. All of them were treated successfully with local injection of pure ethanol. Our trial of local injection of pure ethanol in patients with Dieulafoy ulcers showed that endoscopic hemostasis is effective in these patients. Endoscopic diagnosis and treatment enables bleeding, blood transfusion to be less avoids an emergency surgery. In conclusion, we believe that the endoscopic hemostasis with local injection of pure ethanol is an effective therapeutic method in Dieulafoy ulcer patients.

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Accession: 005359299

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