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Hemostatic effect of hemostasis by endoscopic local injection of hypertonic saline epinephrine solution for acute gastroduodenal mucosal bleeding



Hemostatic effect of hemostasis by endoscopic local injection of hypertonic saline epinephrine solution for acute gastroduodenal mucosal bleeding



Gastroenterological Endoscopy 27(9): 1762-1771



For the purpose of arresting hemorrhage from the upper digestive tract, endoscopic local injection of the HS-E solution has been performed for 38 AGML and ADML cases of serious systemic disease at our hospital from October 1978 to December 1983. Thirty eight cases of serious systemic disease were as follows; liver failure, 10; cerebrovascular attack, 6; renal failure, 5: heart failure, 5; post operative bleeding, 5; multiple bone fracture, 2 and others, 5 (Table 1). An exposed vessel within the lesion was detected 32/38 cases (84%). Foci of hemorrhage were mostly small lesions, but wide gastric mucosal bleeding were encoutered in several cases. The site of initial bleeding was mainly located in the upper gastric body along the lesser curvature (Figure 5). Through repeated endoscopy the site of bleeding was observed to migrate in 6 cases, though there is of no rule for it (Figure 6). From the standpoint of serious systemic complication and presence of exposed vessel, endoscopic therapy was recommended. Local injection of HS-E therapy was succeeded in arresting acute gastroduodenal mucosal bleeding in 36/38 (94.7%) (Table 2). Because tissue damage by HS-E solution is minimal, local injection of HS-E solution can be repeated and applied for various types of bleeding including wide spreaded mucosal bleeding.

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Accession: 005559334

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