Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding
Journal
Gastrointestinal Endoscopy
Journal Volume
55
Journal Issue
7
Pages
842-846
Date Issued
2002
Author(s)
Abstract
Background: Mallory-Weiss syndrome with active bleeding requires effective hemostasis. This is an investigation of the respective efficacy and safety of endoscopic hemoclip placement and endoscopic epinephrine injection in Mallory-Weiss syndrome. Methods: Thirty-five patients with Mallory-Weiss syndrome with spurting vessels or oozing in a university hospital were enrolled prospectively and randomly assigned to endoscopic hemoclip placement (18 patients) or endoscopic epinephrine injection (17 patients) performed by 4 endoscopists with similar clinical experiences. Demographic characteristics, endoscopic variables, and outcome parameters as well as rates of hemostasis and recurrent bleeding were analyzed. Results: The mean (SD) number of hemoclips applied was 2.5 (1.2) and the mean volume of injection was 7.9 (4.3) mL. Primary hemostasis was achieved in all 35 patients. In each group there was 1 case of recurrent bleeding. Secondary hemostasis was achieved by repeating the same procedures as at randomization in both cases. There were no significant differences in age, gender, prior ingestion of alcohol, presenting symptoms, hemoglobin level, shock, comorbid diseases, bleeding stigmata, tear location, blood transfusion, or hospitalization between the groups. There were no procedure-related complications in either group; surgery was not required in any patient. For both groups, there were no second episodes of recurrent bleeding, procedure-related complication, or need of operation. Conclusion: Endoscopic hemoclip placement and endoscopic epinephrine injection are equally effective and safe for the management of active bleeding in Mallory-Weiss syndrome, even in patients with shock or comorbid diseases. Copyright ? 2002 by the American Society for Gastrointestinal Endoscopy.
SDGs
Other Subjects
adrenalin; adrenalin; vasoconstrictor agent; adult; aged; alcohol consumption; article; blood transfusion; clinical article; clip; comorbidity; controlled study; endoscopic surgery; female; hemostasis; human; injection; male; Mallory Weiss syndrome; priority journal; randomization; recurrent disease; safety; shock; university hospital; bleeding; clinical trial; comparative study; controlled clinical trial; digestive tract endoscopy; esophagus disease; Mallory Weiss syndrome; middle aged; outcome assessment; pathology; prospective study; randomized controlled trial; surgical instrument; Adult; Aged; Endoscopy, Digestive System; Epinephrine; Esophageal Diseases; Female; Hemorrhage; Humans; Injections; Male; Mallory-Weiss Syndrome; Middle Aged; Outcome Assessment (Health Care); Prospective Studies; Surgical Instruments; Vasoconstrictor Agents
Publisher
Mosby Inc.
Type
journal article