Application of endoscopic hemoclips for nonvariceal bleeding in the upper gastrointestinal tract

Abstract

AIM:To investigate acute nonvariceal bleeding in the upper gastrointestinal (GI) tract and evaluate the effects of endoscopic hemoclipping. METHODS:Sixty-eight cases of acute nonvariceal bleeding in the upper GI tract were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated. RESULTS:The 68 cases (male:female = 42:26, age from 9 to 70 years, average 54.4) presented with hematemesis in 26 cases (38.2%), melena in nine cases (13.3%), and both in 33 cases (48.5%). The causes of the bleeding included gastric ulcer (29 cases), duodenal ulcer (11 cases), Dieulafoy's lesion (11 cases), Mallory-Weiss syndrome (six cases), postoperative (three cases), post-polypectomy bleeding (five cases), and post-sphincterotomy bleeding (three cases); 42 cases had active bleeding. The mean number of hemoclips applied was four. Permanent hemostasis was obtained by hemoclip application in 59 cases; 6 cases required emergent surgery (three cases had peptic ulcers, one had Dieulafoy's lesion, and two were caused by sphincterotomy); three patients died (two had Dieulafoy's lesion and one was caused by sphincterotomy); and one had recurrent bleeding with Dieulafoy's lesion 10 mo later, but in a different location. CONCLUSION:Endoscopic hemoclip application was an effective and safe method for acute nonvariceal bleeding in the upper GI tract with satisfactory outcomes.

Mortality in high-risk patients with bleeding Mallory–Weiss syndrome is similar to that of peptic ulcer bleeding. Results of a prospective database study

“…Peptic ulcer bleeding is still the most common cause of nonvariceal upper GI bleeding and there are a lot of studies that have been conducted to identify the risk factors for mortality in those patients [5][6][7]. Although Mallory-Weiss syndrome is a relatively common cause of upper GI bleeding, accounting for up to 15% of cases [8,9], to our knowledge there are no large prospective studies that systematically analyzed the mortality in patients with bleeding Mallory-Weiss syndrome and the risk factors influencing mortality in those patients.…”

Upper gastrointestinal bleeding: risk factors for mortality in two urban centers in Latin America

“…In the studied group, the interventional endoscopy therapy was unimodal-injection epinephrine. The efficacy of this treatment is suboptimal and must be used in combination with other methods (22)(23)(24).…”

Early postoperative anastomotic hemorrhage after gastrectomy for gastric cancer

“…Tang et al [19] reported a successful case of endoscopic hemostasis using endoclips for anastomotic bleeding after gastric bypass surgery. Guo et al [20] reported that, in 92.5% of patients with bleeding from peptic ulcers, permanent hemostasis was achieved using endoscopic clips. Endoscopic intervention is certainly noninvasive compared to reoperation.…”