| Theme | Complications and their Managements for Gastrointestinal Endoscopy | |
|---|---|---|
| Title | Management of Unsuccessful Endoscopic Hemostasis | |
| Publish Date | 2002/07 | |
| Author | Satoshi Tanabe | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Tadashi Kitamura | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Yasushi Maesawa | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Katsuhiko Higuchi | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Toru Sasaki | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Norisuke Nakayama | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Hiroshi Imaizumi | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Wasaburo Koizumi | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Katsunori Saigenji | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Mayumi Sasaki | Department of Radiology, Kitasato University East Hospital |
| [ Summary ] | Endoscopic hemostasis is widely used for upper gastrointestinal bleeding. Owing to advance in endoscopic hemostasis, many cases of upper gastrointestinal bleeding can now be managed with conservative therapy, but some critical cases still require surgical treatment. Several different techniques for endoscopic hemostasis can be applied. The mechanism of hemostasis by injection of pure ethanol is chemical coagulation, that of the heater probe is electrocoagulation. It is important to underatand the mechanism and characteristics of each method and perform endoscopic hemostasis carefully. The limitations of endoscopic hemostasis in the management of bleeding ulcers were investigated. The characteristics of patients with uncontrolled bleeding were ulcer with large visible vessels and severe concomitant disease. Endoscopic hemostatic therapy was of limited value in patients with severe shock. Recognizing such limitations in time, and thus switching over to IVR or the surgical approach, is important. |
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