De Angelis Claudio Giovanni, Cortegoso Valdivia Pablo, Rizza Stefano, Venezia Ludovica, Rizzi Felice, Gesualdo Marcantonio, Saracco Giorgio Maria, Pellicano Rinaldo
Gastroenterology and Digestive Endoscopy Unit, AOU Città della Salute e della Scienza, University of Turin, 10126 Turin, Italy.
J Clin Med. 2020 Mar 21;9(3):866. doi: 10.3390/jcm9030866.
Endoscopic injection of glues, clotting factors, or sclerosing agents is a well-known therapy for the treatment of non-variceal upper gastrointestinal bleeding (NVUGIB), but less is known about endoscopic ultrasound (EUS)-guided treatments. In this setting, literature data are scarce, and no randomized controlled trials are available. We performed a review of the existing literature in order to evaluate the role of EUS-guided therapies in the management of NVUGIB. The most common treated lesions were Dieulafoy's lesions, pancreatic pseudoaneurysms, and gastrointestinal stromal tumors (GISTs). Mostly, the treatments were performed as a salvage option after failure of conventional endoscopic hemostatic attempts, showing good efficacy and a good safety profile, also documented by Doppler monitoring of treated lesions. EUS-guided therapies may be an effective option in the treatment of refractory NVUGIB, thus avoiding radiological or surgical management. Nevertheless, available literature still lacks robust data.
内镜下注射胶水、凝血因子或硬化剂是治疗非静脉曲张性上消化道出血（NVUGIB）的一种众所周知的疗法，但关于内镜超声（EUS）引导下的治疗了解较少。在这种情况下，文献数据稀缺，且尚无随机对照试验。我们对现有文献进行了综述，以评估EUS引导下的疗法在NVUGIB管理中的作用。最常见的治疗病变是Dieulafoy病变、胰腺假性动脉瘤和胃肠道间质瘤（GIST）。大多数情况下，这些治疗是在传统内镜止血尝试失败后作为挽救措施进行的，显示出良好的疗效和安全性，经治疗病变的多普勒监测也证实了这一点。EUS引导下的疗法可能是治疗难治性NVUGIB的有效选择，从而避免放射学或手术治疗。然而，现有文献仍然缺乏有力的数据。
