Evaluation of Endoscopic Hemostasis in Upper Gastrointestinal Bleeding Related to Mallory-Weiss Syndrome

Abstract

Our results suggested that endoscopic hemostasis is not necessary in patients without active bleeding stigmata, and the mechanical hemostatic method is more effective than HSE injection in patients with active bleeding stigmata.

Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding

“…However, when bleeding is active and severe, patients require surgical treatment or nonsurgical therapeutic approaches [4,5] . Several endoscopic methods have been used to treat actively bleeding MWS, including injection of different agents, electrocoagulation, application of hemoclips, and band ligation [8,18] . Thermal coagulation or injection therapies have been used successfully to control active bleeding from MWS [10][11][12]21] .…”

“…EBL is technically easier to perform than other methods, with the lesions well viewed under direct pressure and suction from the transparent ligation cap [20] . The use of EBL for treatment of patients with bleeding MWS has been described in several studies [13][14][15]18,20,24] . Our study also demonstrated high successful rates of primary and permanent hemostasis in such cases.…”

“…It is effective in the management of bleeding from a Mallory-Weiss tear [18,19,26] . Compared with cautery or sclerotherapy, it may be a safer option in the management of bleeding from MWS because of the lack of additional tissue damage with endoclips [8,19] .…”

“…However, injection hemostasis may be incomplete for patients with a large and/or long plexuses of vessels and coagulation has the risk of producing transmural injury and perforation due to relatively thin esophageal wall [13] . Mechanical www.wjgnet.com endoscopic methods have recently become one of the therapeutic options for treating patients with actively bleeding MWS [13][14][15][16][17][18][19][20] . Among the mechanical methods, endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP) both has merits and problems related to the hemostatic mechanism and technical procedure itself.…”

Mallory-Weiss sendromunun argon plazma koagülasyonu ile tedavisi

“…For patients with MWS, the reported rates of primary hemostasis obtained with epinephrine injection range from 93% to 100%. However, bleeding recurs in 5.8% to 44% of patients with actively bleeding MWS (10,11). Furthermore, in thermal endoscopic therapy, endoscopists have to be careful to manage the relatively thin esophageal wall and few fibrotic bases in patients with MWS.…”