Factors predicting failure of endoscopic injection therapy in bleeding duodenal ulcer

Brullet, Enric; Calvet, Xavier; Campo, Rafael; Rué, Montserrat; Catot, L; Donoso, L

doi:10.1016/s0016-5107(06)80110-0

Cited by 92 publications

(66 citation statements)

References 24 publications

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“…Bien que la prise en charge des HDH se soit améliorée, la mortalité reste comprise entre 5 et 10 % dans le monde et est parfois même plus élevée dans certaines séries hospitalières [32][33][34][35]. Le pronostic semble en fait étroitement lié au terrain et à la survenue d'une récidive hémorragique précoce [13].…”

Section: Discussionunclassified

Épidémiologie des hémorragies digestives hautes en Tunisie

et al. 2010

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L'hémorragie digestive haute demeure une cause fréquente d'hospitalisation, de morbidité et de mortalité. Les études épidémiologiques sont limitées dans notre pays. But : Déterminer les causes et l'évolution des patients ayant une hémorragie digestive haute, colligés au CHU de Monastir. Matériels et méthodes : Les dossiers de 874 patients qui ont subi une endoscopie digestive haute pour hémorragie digestive pendant une durée de dix ans (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) ont été rétro-spectivement analysés. Résultats : Les hémorragies digestives hautes ont représenté 5,3 % de l'ensemble des endoscopies digestives hautes. On avait noté une nette prédominance masculine (63,1 %), avec un âge moyen de 54 ± 12 ans. L'origine de saignement a été détectée dans 90 % des cas. La précision diagnostique était plus grande quand l'endoscopie est pratiquée dans les 24 premières heures suivant l'apparition de l'hémorragie, et en présence de l'hématémèse. L'ulcère gastroduodénal est la cause la plus fréquente de l'hémorragie digestive haute (50,5 %), suivi des gastroduodénites hémorragiques (24 %). La prévalence de l'hémorragie digestive par rupture des varices oesogastriques était de 9,49 %. Le traitement endoscopique a été utilisé dans 103 cas (11,7 %). Une intervention chirurgicale a été effectuée chez 51 patients (5,83 %), incluant 9,9 % des patients ayant un ulcère hémor-ragique. Trente-six patients étaient décédés (4,1 %). Conclusion : L'ulcère hémorragique est la cause la plus fré-quente d'hémorragie digestive dans notre pays. La mortalité était élevée dans le groupe des patients ayant saigné par rupture des varices oesogastriques. La plupart des cas d'hémor-ragie digestive haute peuvent être traités par hémostase endoscopique, quand l'endoscopie diagnostique établit la source. Mots clésHémorragie digestive haute · Ulcère gastroduodénal · Gastroduodénite hémorragique · Endoscopie Abstract Background: Acute upper gastrointestinal bleeding (UGIB) continues to be a common cause of hospital admission and morbidity and mortality. Epidemiological studies are still limited in our country. Aim and objectives: The aim of this study is to determine the causes and outcome of patients with UGIB presenting at the teaching hospital of Monastir. Materials and methods: The study was carried out at the teaching hospital of Monastir. The records of 874 patients who underwent endoscopy for UGIB over a period of 10 years (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) were retrospectively analysed. Results: The acute UGIB represented 5.3% of all high digestive endoscopy. Male predominance (63.1%) was noted with an average age of 54 ± 12 years. A bleeding site could be detected in 75.6% of the patients. Diagnostic accuracy was greater within the first 24 hours of the bleeding onset and in the presence of hematemesis. Peptic ulcer was the main cause of UGIB (50.5%) followed by erosive mucosal disease (24%). The prevalence of variceal bleeding was 9.49%. Endoscopic treatment was used in 103 case...

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Section: Discussionunclassified

Épidémiologie des hémorragies digestives hautes en Tunisie

et al. 2010

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“…Other factors which are prognostic for early recurrent haemorrhage include: patient age over 65 years, an admission haemoglobin !8 g/dl, clinical shock, haematemesis, recurrent bleeding, severe comorbidity or coagulopathies, an inhospital bleed, the need for transfusions of 15 red blood cell units (RBCU) in the first 24 h after admission or the need for emergency surgery [6,23,24]. Prognostic factors indicative of the failure of endoscopic treatment to control bleeding include: ulcer diameter 12 cm and shock on admission [25,26].…”

Section: Peptic Ulcersmentioning

confidence: 99%

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Jenkins¹

1999

Digestion

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“…Other factors which are prognostic for early recurrent haemorrhage include: patient age over 65 years; an admission haemoglobin !8 g/dl; clinical shock; haematemesis; recurrent bleeding; severe comorbidity or coagulopathies; an in-hospital bleed; the need for transfusions of 15 red blood cell units (RBCU) in the first 24 h after admission, or the need for emergency surgery [6,23,24]. Prognostic factors indicative of the failure of endoscopic treatment to control bleeding include: ulcer diameter 12 cm, and shock on admission [25,26].…”

Section: Peptic Ulcersmentioning

confidence: 99%

“…Furthermore, rebleeding per se is a significant prognostic factor with respect to increased mortality [25][26][27][28]. Due to the fact that the natural history of peptic bleeding is complex, this must be taken into account when designing any controlled trials to evaluate therapy to control non-variceal UGI bleeding.…”

Section: Peptic Ulcersmentioning

confidence: 99%

Somatostatin in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding

Jenkins

Poulianos

Coraggio

et al. 1998

Dig Dis

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The efficacies of somatostatin and octreotide have been widely studied in the control of bleeding from oesophageal varices. It has also been suggested that these drugs may be useful for the control of non-variceal upper gastrointestinal (UGI) bleeding, including that from peptic ulcers. In approximately 80% of patients presenting with non-variceal UGI bleeding, haemorrhage ceases spontaneously and does not recur. However, the remaining 20% of patients require active treatment. Results from recent studies have indicated that somatostatin is an effective treatment for the control of non-variceal UGI bleeding in high-risk patients, i.e. those in whom haemorrhage does not cease spontaneously or is likely to recur. In contrast there is no good evidence available at present to support a role for octreotide in this indication. The efficacy of somatostatin in controlling bleeding in patients with non-variceal UGI bleeding at high risk of mortality upon admission, or rebleeding following endoscopy, coupled with an excellent safety and tolerability profile, suggests that it may be a valuable therapeutic option in the management of non-variceal bleeding.

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Factors predicting failure of endoscopic injection therapy in bleeding duodenal ulcer

Cited by 92 publications

References 24 publications

Épidémiologie des hémorragies digestives hautes en Tunisie

Épidémiologie des hémorragies digestives hautes en Tunisie

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Somatostatin in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding

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