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World J Gastroenterol. Sep 14, 2009; 15(34): 4322-4326
Published online Sep 14, 2009. doi: 10.3748/wjg.15.4322
Application of endoscopic hemoclips for nonvariceal bleeding in the upper gastrointestinal tract
Shi-Bin Guo, Ai-Xia Gong, Jing Leng, Jing Ma, Lin-Mei Ge
Shi-Bin Guo, Ai-Xia Gong, Jing Leng, Jing Ma, Lin-Mei Ge, Department of Gastroenterology, the Affiliated First Hospital of Dalian Medical University, Dalian 116001, Liaoning Province, China
Author contributions: Guo SB and Gong AX designed and performed the research; Guo SB, Leng J, Ma J, and Ge LM collected and analyzed the data; Guo SB wrote the paper.
Correspondence to: Shi-Bin Guo, Associate Professor, Department of Gastroenterology, the Affiliated First Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian 116001, Liaoning Province, China. gsb@dl.cn
Telephone: +86-411-83635963-2218 Fax: +86-411-84438670
Received: May 8, 2009
Revised: August 7, 2009
Accepted: August 14, 2009
Published online: September 14, 2009
Abstract

AIM: To investigate acute nonvariceal bleeding in the upper gastrointestinal (GI) tract and evaluate the effects of endoscopic hemoclipping.

METHODS: Sixty-eight cases of acute nonvariceal bleeding in the upper GI tract were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated.

RESULTS: The 68 cases (male:female = 42:26, age from 9 to 70 years, average 54.4) presented with hematemesis in 26 cases (38.2%), melena in nine cases (13.3%), and both in 33 cases (48.5%). The causes of the bleeding included gastric ulcer (29 cases), duodenal ulcer (11 cases), Dieulafoy’s lesion (11 cases), Mallory-Weiss syndrome (six cases), post-operative (three cases), post-polypectomy bleeding (five cases), and post-sphincterotomy bleeding (three cases); 42 cases had active bleeding. The mean number of hemoclips applied was four. Permanent hemostasis was obtained by hemoclip application in 59 cases; 6 cases required emergent surgery (three cases had peptic ulcers, one had Dieulafoy’s lesion, and two were caused by sphincterotomy); three patients died (two had Dieulafoy’s lesion and one was caused by sphincterotomy); and one had recurrent bleeding with Dieulafoy’s lesion 10 mo later, but in a different location.

CONCLUSION: Endoscopic hemoclip application was an effective and safe method for acute nonvariceal bleeding in the upper GI tract with satisfactory outcomes.

Keywords: Gastrointestinal hemorrhage; Endoscopy; Hemoclip; Hemostasis