Clinical Gastroenterology Vol.24 No.8(2-2)

Theme Topics of Gastrointestinal Hemorrhage
Title Prevention and Treatment of Bleeding after Endoscopic Surgery in Esophagus and Stomach
Publish Date 2009/07
Author Shouko Ono Division of Endoscopy, Hokkaido University Hospital
Author Mototsugu Kato Division of Endoscopy, Hokkaido University Hospital
Author Yuichi Shimizu Department of Gastroenterology, Hokkaido University Graduate school of Medicine
Author Masahiro Asaka Department o fGastroenterology, Hokkaido University Graduate school of Medicine
[ Summary ] Bleeding and perforations are two major complications associated with endoscopic surgery. Bleeding after gastric endoscopic surgery often occurs and prevention of bleeding is important. To prevent major bleeding incidents, for which blood transfusions or endoscopic hemostasis are necessary, endoscopic clipping or coagulation of exposed vessels seen with iatrogenic ulcers may be required. Antacids are generally administered for promotion of blood coagulation and ulcer healing. Proton-pump inhibitors seem to be better than histamin 2 receptor antagonists for treatment of large iatrogenic ulcers after gastric ESD. Active bleeding after endoscopic surgery should be treated in the same way as general upper gastrointestinal bleeding. Both coagulation forceps and hemoclipping are used for the endoscopic hemostasis procedures after location of bleeding areas.
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