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  • Title: Peptic upper gastrointestinal bleeding: diagnosis and treatment. A monocentric experience on a 5 years period.
    Author: Sporea I, Lazăr D, Popescu A, Sirli R, Goldiş A, Străin M, Tudora A, Dănilă M, Dănilă V, Vernic C.
    Journal: Rom J Intern Med; 2009; 47(4):347-54. PubMed ID: 21179916.
    Abstract:
    AIM: We evaluated all the cases of upper gastrointestinal hemorrhages admitted in the Department of Endoscopy of our Clinic during a 5 years period. MATERIAL AND METHOD: 810 patients were included in our study, 64.3% males and 36.7% females, mean age 58.7 +/- 15.2 years (17-96 years). The main cause of the upper digestive hemorrhage was peptic ulcer (82.6%), equally divided in gastric and duodenal. All the ulcers were assessed according to the Forrest classification. RESULTS: Endoscopic haemostasis was performed in 40% of all cases, only epinephrine injection (1/10,000) in 44.4% of cases; combined therapy (injection + clip or thermocoagulation) in 40.3% of the cases and clip or thermocoagulation alone in 15.3% of the cases. A marked reduction of haemostasis using epinephrine injection alone (as monotherapy) was observed during the period of study. Postendoscopic treatment rebleeding occurred in 19.8% of cases; 3.6% of the patients have had a fatal outcome and surgical treatment was needed in 2.7% of cases. CONCLUSION: In an experienced Department of Endoscopy, the majority of upper gastrointestinal hemorrhages can be endoscopically treated with good results. In the last years, endoscopical haemostatic bitherapy (adrenaline injection+clipping or bipolar coagulation) replaced injection of adrenaline like monotherapy for ulcer hemostasis.
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