Manrique MA, Cruz RJM, Chávez GMA, Pérez VE, Pérez CT, Álvarez CR, Juárez VEI, García MAR, Díaz GDC, Bellacetín FO, Alejo TO, Santamaría AJR

Language: Spanish
References: 10
Page: 93-97
PDF size: 71.19 Kb.

ABSTRACT

Introduction. The upper gastrointestinal bleeding defines like the hemorrhage proximal to the Treitz’s angle. It has an incidence of 50-150 cases per 100,000 habitants and a mortality of 7-10% per year. The most frequent cause of non variceal bleeding is the peptic ulcer in 50% of cases. We count with many scales to predict the risk of rebleeding, being the Forrest scale the most used. The incidence of rebleeding occurs in 10-30% and it’s the most important adverse factor in the outcome. Therefore, the haemostatic methods selection is a very important decision. Objective. Determine the efficacy of the haemostatic methods used in Hospital Juarez de Mexico for the management of upper gastrointestinal non variceal bleeding from 2006 to 2009. Material and methods. We realized a retrospective, prospective and transversal study from January 2006 to September 2009, we reviewed 8660 files and selected those with diagnosis of upper gastrointestinal active bleeding, resulting in 228 files as a total. Results: Of 228 cases, 119 was males (52%) and 109 females (48%), with an average of 59 years in males and 58.5 in females. The principal causes of bleeding in which used haemostatic methods were, duodenal ulcer in 78 cases (34.2%), 89 with gastric ulcer (39%) and 30 with Mallory-Weiss tear (13.1%). We obtained 25 patients with Forrest Ia (11%), 39 Ib (17%), 80 IIa (35%) and 84 IIb (37%). The principal haemostatic methods used were the combined therapy with heater probe plus adrenaline (37%), 32 with adrenaline alone (31.5%) and 63 heater probe alone (27.6%). In 205 cases (89.5%) the endoscopy was perform in the first 24 hours before their hospital admission. Conclusions. The principal cause of upper gastrointestinal non variceal active bleeding was the gastric ulcer. It was predominant in males than females, in relation of Forrest scale were the most frequent IIa and IIb cases. The haemostatic method more frequently used was the combined therapy (adrenaline plus heater probe). In 90.4% of the cases the endoscopy was perform in the 24 hours before the hospital admission and we achieved a success of 98.2% in hemorrhage control. The adequate control of the active bleeding was due to the optimal perform and selection of the endoscopic method in each patient.

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