transendoscopic adrenaline local injection in the control of bleeding gastroduodenal peptic ulcer

ABSTRACT

A prospective randomised trial was performed to assess the efficacy of local injection of adrenaline through upper G.I.T. endoscopy. Among 65 patients admitted with upper G.I.T. haemorrhage, 16 patients with actively bleeding ulcers were identified 8 of them subjected to endoscopic injection of adrenaline g p I. The other 8 patients had no endoscopic treatment g p II. After endoscopy both g p s were managed identically by medical regime and/or emergency operation if required. Bleeding was initially controlled in 7 patients in g p I the remaining patient needed an emergency surgical operation after 24 hours when Medical control failed to arrest bleeding. In g p II 6 patients needed emergency operation to control bleeding and 2 patients improved with Medical control. During post endoscopy period the medium blood transfusion was 2 and 6 units in g p I and II respectively. No complications were observed with adrenaline injection with unchanged heart rate during the injection. Hospital stay in g p I was 3 +/- 7 days and in g p II was 10 +/- 8 days. Reendoscopy after 2 months revealed healing occurring in 75% in g p I and 62.5% in g p II. Local injection of adrenaline is effective in stopping bleeding from actively bleeding gastro duodenal ulcers. This conservative approach offers a worth while option in the management of acute bleeding peptic gastroduodenal ulcer