Factors related to the failure of endoscopic injection therapy for bleeding gastric ulcer.
Gut
; 39(2): 155-8, 1996 Aug.
Article
in En
| MEDLINE
| ID: mdl-8977333
ABSTRACT
BACKGROUND:
Although endoscopic injection therapy is effective in controlling initial haemorrhage from peptic ulcer, between 10% to 30% of patients suffer rebleeding.AIM:
To assess the factors that may predict the failure of endoscopic injection in patients bleeding from high risk gastric ulcer.SUBJECTS:
One hundred and seventy eight patients admitted for a gastric ulcer with a bleeding or a non-bleeding visible vessel were included.METHODS:
Patients received endoscopic therapy by injection for adrenaline and polidocanol. Twelve clinical and endoscopic variables were entered into a multivariate logistic regression model to ascertain their significance as predictive factor of therapeutic failure.RESULTS:
Eighty seven per cent (155 of 178) of patients had no further bleeding after endoscopic therapy. Endoscopic injection failed in 23 (13%) patients 20 (12%) continued to bleed or rebleed, and three (1%) patients could not be treated because of inaccessibility of the lesion. Logistic regression analysis showed that therapeutic failure was significantly related to (1) the presence of hypovolaemic shock (p = 0.09, OR 2.38, 95% CI 0.86, 6.56), (2) the presence of active bleeding at endoscopy (p = 0.02, OR 2.98, 95% CI 1.12, 7.91), (3) ulcer location high on the lesser curvature (p = 0.04, OR 2.79, 95% CI 1.01, 7.69), and (4) ulcer size larger than 2 cm (p = 0.01, OR 3.64, 95% CI 1.34, 9.89).CONCLUSION:
These variables may enable identification of those patients bleeding from gastric ulcer who would not benefit from injection therapy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Polyethylene Glycols
/
Sclerosing Solutions
/
Shock
/
Stomach Ulcer
/
Vasoconstrictor Agents
/
Epinephrine
/
Peptic Ulcer Hemorrhage
/
Endoscopy, Gastrointestinal
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Gut
Year:
1996
Document type:
Article
Affiliation country: