Adrenaline injection for endoscopic haemostasis in non-variceal upper gastrointestinal haemorrhage

Abstract

Over a 30-month period, 53 patients with actively bleeding non-variceal lesions of the oesophagus, stomach or duodenum were treated by endoscopic injection of 1/10,000 adrenaline. Initial haemostasis was obtained in 50 cases, and permanent haemostasis in 44. Emergency surgery for bleeding was required in nine patients overall, and there were four deaths. All lesions requiring surgery were located on the posterior wall of the duodenum or the lesser curve of the stomach, and all but one had evidence of an exposed arterial vessel. Adrenaline injection is an effective, safe and simple method of endoscopic haemostasis.

Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers

“…With the advent of effective means of endoscopic haemostasis, endoscopic treatment has emerged as the first line treatment of ulcer haemorrhage. Many methods, such as laser, contact thermal probes, or injection therapy, have been proved to be clinically useful 1 2 3 4 5 6 7 8 9 10. Which one of these methods is superior remains controversial.…”

Surgical OGD – a dying art?

“…4,5 It is, however, a potentially difficult technique and requires an experienced endoscopist supported by appropriately trained staff and modern equipment. 6 In 1991, a working party published quality standards for the provision of endoscopy services stating that: 'it was no longer acceptable for endoscopy to be performed by untrained medical staff assisted by part-time helpers'. 7 The present study has shown that a decade later this 'unacceptable' situation persists in many hospitals.…”

Local epinephrine facilitates laparoscopic Heller myotomy

“…80 the cystic duct and artery. Topical (1:10,000) or injected (1:100,000) epinephrine solution is used to facilitate hemostasis in other open and endoscopic procedures: bleeding peptic ulcer [3,7,18] and colonic diverticulae [4], endobronchial biopsies [9], subcutaneous mastectomies [20], and tonsillectomies [16].…”