Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers

Vergara, Mercedes; Bennett, Cathy; Calvet, Xavier

doi:10.1002/14651858.cd005584.pub3

Cited by 111 publications

(57 citation statements)

References 58 publications

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“…Active bleeding was encountered in 26.1 % and definitive endotherapy applied in 27.2 % of all patients, whereas epinephrine injection alone was used in only 3.9 % of the cases. There was no difference in the need for endotherapy between the study groups, and surgery was rarely needed, partly because of the active application of definitive endotherapy [17]. Moreover, active bleeding was not associated with increased mortality risk in this study.…”

Section: Discussionmentioning

confidence: 55%

Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding

et al. 2015

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Section: Discussionmentioning

confidence: 55%

Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding

et al. 2015

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“…Chaque méthode a ses défen-seurs, voire ses détracteurs, et il est certainement préférable de privilégier les méthodes dont on possède la maîtrise. Il est classiquement recommandé d'utiliser une bithérapie, en particulier pour les hémorragies en jet et pour les hémorragies avec aspect de vaisseau visible à fort risque de récidive [4,10,12]. Les seuls cas pour lesquels un traitement endoscopique n'est pas recommandé sont les lésions classées Forrest II c et III.…”

Section: Pendant L'endoscopieunclassified

Comment optimiser la prise en charge endoscopique des hémorragies digestives hautes ?

Lesur

Camus

2015

Acta Endosc

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La prise en charge médicale et endoscopique des hémorragies digestives a considérablement amélioré leur pronostic. Malgré ces progrès, il est des situations rares (échec primaire, récidive hémorragique) qui imposent de tenter d'optimiser la prise en charge endoscopique. Le but de cette mise au point est de faire le point sur ces moyens d'optimiser la prise en charge endoscopique des hémorragies digestives hautes pour tenter d'éviter ces situations difficiles qui sont souvent source de mortalité. Mots clésHémorragie digestive · Hémostase endoscopique · Récidive hémorragique · Échec de traitement endoscopique · Seconde endoscopie · Hypertension portale Abstract Prognosis of gastrointestinal bleeding is now better, especially related to combined medical therapy and endoscopic therapy. In spite of these progresses, failure of endoscopic therapy (initial failure, further bleeding) can occur, and then, optimize the endoscopic therapy is necessary. The aims of this review are to discuss how to optimize the management of upper gastrointestinal bleeding for avoiding these difficult situations which are oftently associated with mortality.

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“…Nevertheless, no differences were seen in the need for surgery or mortality [37]. Such an approach should of course be considered if a variceal cause of bleeding is suspected [38], or if patients are exsanguinating from any upper gastrointestinal tract etiology.…”

Section: Octreotide and Somatostatinmentioning

confidence: 99%

“…Endoscopic therapy is warranted for high-risk lesions that is, Forrest classification 1a, 1b, 2a, and 2b, 2b because of their greatest propensities for rebleeding if left untreated. Meta-analyses have confirmed that endoscopic hemostasis in this group of patients results in significant improvements in rebleeding, but have been underpowered to show any better improvement in the need for surgery or mortality [32,36,38,50]. Although all endoscopic techniques provide benefit, injection of epinephrine alone is superior to medical management alone, but is inferior to all other methods and should no longer be used as a sole endoscopic treatment when other methods are available.…”

Section: Endoscopic Therapeutic Modalitiesmentioning

confidence: 99%

The Acute Management of Nonvariceal Upper Gastrointestinal Bleeding

Dhahab

Barkun

2012

Ulcers

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Background. The mortality from nonvariceal upper gastrointestinal bleeding is still around 5%, despite the increased use of protonpump inhibitors and the advancement of endoscopic therapeutic modalities. Aim. To review the state-of-the-art management of acute non variceal upper gastrointestinal bleeding from the presentation to the emergency department, risk stratification, endoscopic hemostasis, and postendoscopic consolidation management to reduce the risk of recurrent bleeding from peptic ulcers. Methods. A PubMed search was performed using the following key words acute management, non variceal upper gastrointestinal bleeding, and bleeding peptic ulcers. Results. Risk stratifying patients with acute non variceal upper gastrointestinal bleeding allows the categorization into low risk versus high risk of rebleeding, subsequently safely discharging low risk patients early from the emergency department, while achieving adequate hemostasis in high-risk lesions followed by continuous proton-pump inhibitors for 72 hours. Dual endoscopic therapy still remains the recommended choice in controlling bleeding from peptic ulcers despite the emergence of new endoscopic modalities such as the hemostatic powder. Conclusion. The management of nonvariceal upper gastrointestinal bleeding involves adequate resuscitation, preendoscopic risk assessment, endoscopic hemostasis, and post endoscopic pharmacological and nonpharmacological treatment.

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Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers

Cited by 111 publications

References 58 publications

Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding

Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding

Comment optimiser la prise en charge endoscopique des hémorragies digestives hautes ?

The Acute Management of Nonvariceal Upper Gastrointestinal Bleeding

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