Subject(s)
Anti-Inflammatory Agents/adverse effects , Ethanol/adverse effects , Gastrointestinal Hemorrhage/chemically induced , Salicylates/adverse effects , Acute Disease , Adolescent , Adrenal Cortex Hormones/adverse effects , Adult , Aged , Child , Gastrointestinal Hemorrhage/pathology , Humans , Middle Aged , Potassium/adverse effectsABSTRACT
Emergency endoscopy on 332 patients with acute upper gastrointestinal bleeding showed that 178 had peptic ulcers; 28 of these were actively bleeding (spurting) and 108 showed stigmata of recent haemorrhage (vessels or spots in the ulcer base) suggesting a risk of rebleeding. These 136 patients were randomly allocated to Argon laser photocoagulation or to no additional therapy (controls) at the time of initial endoscopy. All patients received conventional management, and the controlling clinicians did not know whether or not the laser had been used in any individual patients. The laser system proved both simple and safe in use. Initial haemostasis was achieved by the laser in 10 of 15 'spurting vessels', but four of 13 'control' spurting vessels also stopped bleeding spontaneously. Overall, there were no statistically significant differences between the laser treated and control groups in terms of rebleeding, the need for surgical intervention, or death. These results require amplification in larger trials, and comparison with other studies using different protocols and other haemostatic methods.
Subject(s)
Duodenal Ulcer/complications , Laser Therapy , Lasers , Peptic Ulcer Hemorrhage/surgery , Stomach Ulcer/complications , Acute Disease , Clinical Trials as Topic , Emergencies , Endoscopy , Humans , Random Allocation , RecurrenceABSTRACT
Argon laser photocoagulation was applied at the time of endoscopy in 60 patients actively bleeding from gastric and duodenal ulcers. Initial haemostasis was achieved in 48 patients (80%), of whom 5 re-bled within the same hospital admission.
