[Endoscopic haemostasis of bleeding duodenal ulcer].

INTRODUCTION

Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. It manifests like: haematemesis, melaena or haemochezia. Diagnostic endoscopy accurately defining the cause of haemorrhage, while therapeutic endoscopy improves prognosis in patients who present with severe bleeding. Endoscopic therapies can be classified as those based on injection, application of heat, or mechanical clips.

PATIENTS AND METHODS

This investigation was conducted in Department of endoscopic haemostasis, Clinic for gastroenterology and hepatology, CCS, using retrospective analysis of patients with acute upper gastrointestinal bleeding during the last five years. The aim of this study was to establish the number of upper gastrointestinal bleeding in our hospital during the last five years, and distribution of income according to type, difficulty, cause factors and risk factors of gastrointestinal bleeding and method of haemostasis.

RESULTS

In Department of endoscopic haemostasis 3954 patients with upper gastrointestinal bleeding were endoscoped, and 33.4% of them had bleeding duodenal ulcer. Male patients were statistically significant more present than female patients in group with duodenal ulcer 71.8%: 28.2%). 79.7% patients with duodenal ulcer had only haematemesis, while 14.4% patients had haematemesis and melaena. 59.1% patients with bleeding duodenal ulcer consumed salicylates and/or non-steroidal anti-inflammatory drugs (NSAIDS) (statistical significant differences chi2 test; p = 0.007). Only endoscopic injection was used: in 36.8% of patients used injection of adrenaline solutions, while in 5.9% of patients used injection of adrenaline and absolute alcohol solutions.

CONCLUSION

Using of therapeutic endoscopy improves better prognosis in patients who present with severe acute upper gastrointestinal bleeding. Endoscopist's experience is an important independent prognostic factor for acute upper gastrointestinal bleeding.