Systemic absorption of epinephrine after endoscopic submucosal injection in patients with bleeding peptic ulcers

Sung, Joseph J.Y.; Chung, S. C. S.; Low, J. M.; Cocks, Robert A.; Tan, Perpetua E.; Leung, Joseph; Oh, T. E.; Li, Arthur K.C.

doi:10.1016/s0016-5107(93)70004-8

Cited by 60 publications

(28 citation statements)

References 13 publications

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“…Regarding the reason for using distilled water rather than epinephrine injection, some scholars agreed that epinephrine injection may result in increased risk of cardiovascular event. Sung and his colleagues [26] found that plasma epinephrine concentration increased significantly for 10 minutes following endoscopic injection and increased the likelihood of adverse cardiovascular events. Distilled water is used rather than epinephrine injection because epinephrine injection may increase the risk of a cardiovascular event.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

Hsu

Wang

et al. 2014

BioMed Research International

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Background. Argon plasma coagulation (APC) is useful to treat upper gastrointestinal bleeding, but its hemostatic efficacy has received little attention. Aims. This investigation attempted to determine whether additional endoscopic injection before APC could improve hemostatic efficacy in treating high-risk bleeding ulcers. Methods. From January 2007 to April 2011, adult patients with high-risk bleeding ulcers were included. This investigation compared APC plus distilled water injection (combined group) to APC alone for treating high-risk bleeding ulcers. Outcomes were assessed based on initial hemostasis, surgery, blood transfusion, hospital stay, rebleeding, and mortality at 30 days posttreatment. Results. Totally 120 selected patients were analyzed. Initial hemostasis was accomplished in 59 patients treated with combined therapy and 57 patients treated with APC alone. No significant differences were noted between these groups in recurred bleeding, emergency surgery, 30-day mortality, hospital stay, or transfusion requirements. Comparing the combined end point of mortality plus the failure of initial hemostasis, rebleeding, and the need for surgery revealed an advantage for the combined group (P = 0.040). Conclusions. Endoscopic therapy with APC plus distilled water injection was no more effective than APC alone in treating high-risk bleeding ulcers, whereas combined therapy was potentially superior for patients with poor overall outcomes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

Hsu

Wang

et al. 2014

BioMed Research International

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“…The spurting haemorrhage is first controlled by injection, which does not need to be accurately targeted as injection close to the bleeding point will suffice to control bleeding. As submucosally injected adrenaline does not damage tissue or have appreciable systemic effects, large volumes can be used without fear of complications 24. Once the active bleeding is controlled the heat probe can be targeted on to the bleeding vessel to apply firm tamponade and captive coagulation.…”

Section: Discussionmentioning

confidence: 99%

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

Chung

Lau

Sung

et al. 1997

BMJ

205

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“…Although endoscopic epinephrine injection is one of the most effective treatment modalities used to control gastrointestinal bleeding, it may rarely cause a hypertensive attack and amaurosis fugax, a very serious complication which develops very rarely 1 . As in the case reported here, these cardiovascular events are accompanied by a concurrent rise in plasma epinephrine levels that occurs after an epinephrine injection to duodenal and gastric ulcers, beginning just after injection and resolving within 15 min 2 . Up to now, endoscopic epinephrine injection related amaurosis fugax has never been reported.…”

mentioning

confidence: 50%

“…Up to now, endoscopic epinephrine injection related amaurosis fugax has never been reported. Although Sung et al 2 . reported a four‐ to five‐fold increase in plasma epinephrine levels following an endoscopic submucosal injection, adverse cardiovascular effects have not been reported.…”

mentioning

confidence: 98%

Endoscopic epinephrine injection induced amaurosis fugax

Altıntaş

Sayici

Sezgın

2006

J of Gastro and Hepatol

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Obstructing hamartoma of Brunner's glands of the duodenum. Dig. Dis. Sci. 1982; 27 : 279-82. 7 Reisner RM, Nava HR. Large Brunner's gland hamartoma simulating a pancreatic mass with obstruction and bleeding. Surg. Endosc. 1996; 10 : 341-3. 8 Beeman EA. Hamartoma of the duodenum. a tumor composed of Brunner's glands and fat. Gastroenterology 1965; 48 : 256-60. 9 Goldman RL. Hamartomatous polyps of Brunner's glands. Gastroenterology 1963; 44 : 57-62. 10 Remine WH, Brown PW Jr, Gomes MM, Harrison EG Jr. Polypoid hamartomatous of Brunner's glands. Report of six surgical cases. Arch. Surg. 1970; 100 : 313-16. 11 Walden DT, Marcon NE. Endoscopic injection and polypectomy for bleeding Brunner's gland hamartoma. Case report and expanded literature review. Gastrointest. Endosc. 1998; 47 : 403-7. 12 Grossman MI. The glands of Brunner. Physiol. Rev. 1958; 38 : 675-9. 13 Levine JA, Burgart LJ, Batts KP, Wang KK. Brunner's gland hamartomas: clinical presentation and pathological features of 27 cases. Am. J. Gastroenterol. 1995; 90: 290-4. 14 Shirazi SS, Deckinga BG. Brunner's gland adenoma of the duodenum. Arch. Surg. 1977; 112: 306-7. 15 Barnhart GR, Maull KI. Brunner's gland adenomas: clinical presentation and surgical management. South Med. J. 1979; 72: 1537-9. 16 Kostakis A, Kouraklis G. Hamartoma of Brunner's glands with heterotopic pancreatic tissue causing massive haematemesis and pyloric obstruction. Dig. Dis. Sci. 1994; 39: 1595-6. 17 Matsui T, Iida M, Fujishima M, Sakamoto K, Watanabe H. Brunner's gland hamartoma associated with microcarcinoids. South Med. J.

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Systemic absorption of epinephrine after endoscopic submucosal injection in patients with bleeding peptic ulcers

Cited by 60 publications

References 13 publications

Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

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

Endoscopic epinephrine injection induced amaurosis fugax

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