Predictors of hemostatic failure after adrenaline injection in patients with peptic ulcers with non-bleeding visible vessel

Scandinavian Journal of Gastroenterology
K C ThomopoulosV N Nikolopoulou

Abstract

Non-bleeding visible vessel (NBVV) in patients with bleeding peptic ulcer is associated with a high risk of rebleeding. The aim of this study was to define factors associated with failure of endoscopic hemostasis and rebleeding in patients with NBVV. Clinical and endoscopic parameters related to failure of endoscopic hemostasis with adrenaline in 191 bleeding peptic ulcer patients with NBVV were evaluated. Endoscopic hemostasis was permanently successful in 154 patients (80.6%). Emergency surgical hemostasis for rebleeding was required in 37 patients (19.4%). Univariate analysis showed that therapeutic failure was significantly related to the presence of shock on admission (P=0.003), posterior duodenal ulcers (P=0.001), peptic ulcer history (P=0.001), previous peptic ulcer bleeding (P=0.002), or lack of history of non-steroidal anti-inflammatory drugs consumption, when compared to use of such drugs (P=0.04). Patients where therapy failed had lower hemoglobin levels at admission (7.8+/-1.9 g/dL versus 10+/-2.4 g/dL, P=0.005). In a multivariate analysis low hemoglobin (P<0.001) as well as history of previous peptic ulcer bleeding (P=0.002) and posterior duodenal ulcers (P=0.001) were negative predictors. Using the mean value of h...Continue Reading

References

Jun 1, 1989·The British Journal of Surgery·G M FullartonW R Murray
Mar 1, 1986·Gastroenterology·C P SwainJ P O'Sullivan
Sep 15, 1994·The New England Journal of Medicine·L Laine, W L Peterson
Mar 1, 1997·Scandinavian Journal of Gastroenterology·K C ThomopoulosC E Vagianos
Sep 1, 2000·Gastrointestinal Endoscopy·C J Gostout
Jun 27, 2001·Scandinavian Journal of Gastroenterology·K C ThomopoulosV N Nikolopoulou
Jan 16, 2003·The American Journal of Gastroenterology·Brennan M R SpiegelNimish B Vakil

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Citations

Aug 30, 2008·The New England Journal of Medicine·Ian M GralnekMarc Bardou
Nov 26, 2009·La Presse médicale·Stéphane LecleirePhilippe Ducrotté
Sep 9, 2011·Alimentary Pharmacology & Therapeutics·P García-IglesiasX Calvet
Oct 1, 2008·Journal of Gastroenterology and Hepatology·Anne C TravisJohn R Saltzman
Dec 13, 2005·Journal of Clinical Gastroenterology·Yen-Chun PengDar-Yu Yang
Aug 8, 2008·The American Journal of Gastroenterology·B Joseph ElmunzerLoren Laine

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