Endoscopic ligation for patients with active bleeding Mallory-Weiss tears

Günay, Kayıhan; Cabıoğlu, Neslihan; Barbaros, Umut; Taviloğlu, Korhan; Ertekın, Cemalettın

doi:10.1007/s004640000357

Cited by 15 publications

(11 citation statements)

References 14 publications

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“…Multipolar electrocautery appears to be the most effective therapy, but epinephrine injection, clips, or band ligation also appear to be effective. [59][60][61][62][63] There are no prospective trials comparing treatment methods for Mallory-Weiss tears. Uncontrolled bleeding may require angiographic therapy or surgery.…”

Section: Esophageal Lesionsmentioning

confidence: 98%

The role of endoscopy in the management of acute non-variceal upper GI bleeding

Hwang¹,

Fisher²,

Ben–Menachem³

et al. 2012

Gastrointestinal Endoscopy

306

205

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Section: Esophageal Lesionsmentioning

confidence: 98%

The role of endoscopy in the management of acute non-variceal upper GI bleeding

Hwang¹,

Fisher²,

Ben–Menachem³

et al. 2012

Gastrointestinal Endoscopy

306

205

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“…EBL is technically easier to perform than other methods, with the lesions well viewed under direct pressure and suction from the transparent ligation cap [20] . The use of EBL for treatment of patients with bleeding MWS has been described in several studies [13][14][15]18,20,24] . Our study also demonstrated high successful rates of primary and permanent hemostasis in such cases.…”

Section: Peer Reviewmentioning

confidence: 99%

“…However, injection hemostasis may be incomplete for patients with a large and/or long plexuses of vessels and coagulation has the risk of producing transmural injury and perforation due to relatively thin esophageal wall [13] . Mechanical www.wjgnet.com endoscopic methods have recently become one of the therapeutic options for treating patients with actively bleeding MWS [13][14][15][16][17][18][19][20] . Among the mechanical methods, endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP) both has merits and problems related to the hemostatic mechanism and technical procedure itself.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding

Cho¹,

Chae²,

Kim³

et al. 2008

WJG

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“…Perforation is extremely rare, as opposed to MPEC. A case report [21] of successful control of an active bleed secondary to MWT occurring during endoscopy, and two small series of cases reports [22,23] of successful treatment of active bleeding secondary to MWT using EBL were reported, all with a 100% success rate in achieving hemostasis and no complications.…”

Section: Endoscopic Therapymentioning

confidence: 97%

Therapeutic alternatives for the Mallory-Weiss tear

Morales

Baum

2003

Curr Treat Options Gastro

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The Mallory-Weiss tear (MWT) is a frequent cause of upper gastrointestinal bleeding. It has been diagnosed more frequently since endoscopy was introduced. Once the diagnosis has been made, several treatment options are available. The treatment modality chosen depends on the type and location of the lesion, the patient's comorbid conditions, the availability of the different therapeutic modalities, and the experience of the endoscopist with each of these different modalities. In general, if the MWT is not actively bleeding at the time of endoscopy, no further treatment is needed owing to a low risk of rebleeding, unless a visible vessel is present. In the presence of a visible vessel or an actively bleeding vessel, then we recommend the use of any of the endoscopic treatment modalities discussed later in this article depending on the patient's condition and clinical scenario. Our review of the literature suggests that multipolar electric coagulation (MPEC) is the treatment modality with better evidence-based support for safety and bleeding control. MPEC has been associated only with very few complications. It should be avoided when esophageal varices are suspected because it may precipitate and aggravate bleeding. In such instances, either polidocanol injection or endoscopic band ligation of the tear is recommended, which is emerging as a safe and effective treatment modality even in patients without varices. In addition, epinephrine injection is an effective first-line modality. However, it should be avoided in patients with history of coronary artery disease owing to the potential for systemic absorption. Endoscopic hemoclipping (EH) is another useful treatment option and is emerging as a first-line modality. However, it is not widely available in all endoscopy emergency units. If it is available, it is a great alternative. Finally, if bleeding continues or recurs despite endoscopic therapy, the patient should be referred for surgical treatment. However, if the patient is not a surgical candidate, then radiologic hemostasis with selective vasopressin or Gelfoam embolization represents a viable treatment alternative that may be used depending on availability of a specialized interventional radiologist.

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Endoscopic ligation for patients with active bleeding Mallory-Weiss tears

Abstract: Endoscopic ligation can be performed easily and without any complications such as perforation or delayed hemorrhage in patients with actively bleeding nonfibrotic MWTs.

Cited by 15 publications

References 14 publications

The role of endoscopy in the management of acute non-variceal upper GI bleeding

The role of endoscopy in the management of acute non-variceal upper GI bleeding

Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding

Therapeutic alternatives for the Mallory-Weiss tear

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