Role of Endoscopy in Upper Gastrointestinal Bleeding in Patients with Malignancy

Abstract

A retrospective review of upper gastrointestinal bleeding in 55 patients with malignant disease is presented here. Major causative factors seem to be superficial gastritis and gastric erosions. With aggressive endoscopy, a diagnostic accuracy of 90 percent has been achieved. However, having the exact diagnosis too often has little significance on the final outcome of these critically ill patients, unless therapy directed against bleeding can provide time for effective antineoplastic treatment. With the better understanding of the pathology of the superficial gastric erosions, a better program of management can be evolved.

The efficacy of Hemospray in patients with upper gastrointestinal bleeding from tumor

“…Tumor-related gastrointestinal bleeding is currently a challenging clinical problem 1 . A retrospective review of upper gastrointestinal bleeding in 55 patients with primary or metastatic gastrointestinal malignancy revealed that up to 20 % were related to tumor invading gastrointestinal lumen and causing bleeding 2 . Currently, endoscopy is recommended as the main diagnostic tool to locate the site of bleeding 2 3 .…”

“…A retrospective review of upper gastrointestinal bleeding in 55 patients with primary or metastatic gastrointestinal malignancy revealed that up to 20 % were related to tumor invading gastrointestinal lumen and causing bleeding 2 . Currently, endoscopy is recommended as the main diagnostic tool to locate the site of bleeding 2 3 . Unfortunately, current endoscopic hemostatic methods including coaptation therapy, argon plasma coagulation, and mechanical hemostasis do not reliably control active bleeding, with rates of successful immediate hemostasis as low as 40 % and a significant short-term rebleeding rate (up to 30 %) 1 4 5 .…”