Endoscopic Ligation for Non-Esophageal Variceal Upper Gastrointestinal Hemorrhage

Abstract

Our findings suggest that endoscopic ligation is an easy and effective method of treatment for patients with gastrointestinal hemorrhage not from esophageal varices, and is safe even in patients with poor general health.

The role of endoscopy in the management of acute non-variceal upper GI bleeding

“…Endoscopic ligation, laser, argon plasma coagulation, coaptive cautery methods, and sclerotherapy can be effective therapies for UGIB due to vascular abnormalities. [64][65] There are no prospective trials comparing treatment methods for acute UGIB caused by vascular malformations.…”

Endoscopic ligation for patients with active bleeding Mallory-Weiss tears

“…The high percentage (57%) of our actively bleeding patients (57%) can be explained by our Emergency Surgery Service, which is a reference center for actively and severely bleeding patients. In these actively bleeding patients, endoscopic managements such as injection therapy, sclerotherapy, or band ligation are required frequently [16,13,18]. Endoscopic submucosal injection of epinephrine is an effective, simple, and inexpensive method for the treatment of bleeding MWTs [11].…”

“…However, only a few patients whose bleeding MWTs were treated with endoscopic ligation have been reported [18]. Endoscopic band ligation can be used effectively for bleeding lesions in nonfibrotic tissue.…”

“…This simple effective technique has been used in the management of nonvaricceal hemorrhage after polypectomy [12], gastric angiodysplasia [2], and Dieulafoy's ulcer of the stomach [1]. However, only a few patients with active bleeding Mallory-Weiss tears (MWTs) who were treated with endoscopic ligation have been reported [18]. To further address this issue, four cases of actively bleeding MWTs treated with endoscopic ligation are presented.…”

Endoscopic management of lower gastrointestinal bleeding

“…The multiband ligating devices designed for gastroscopies can be modified by tying a 60-to 80-cm lengthening piece of Dacron (Dupont, Wilmington, DE) fishing line to the existing trip cord or wire to lengthen it [20]. Rubber band ligation has been reported as effective in the treatment of hemorrhage secondary to arteriovenous malformations [21], post-polypectomy bleeding [22][23][24], Dieulafoy's lesions and bleeding colonic diverticula [25], and hemorrhoids.…”