Varis dışı üst gastrointestinal sistem kanamasında endoskopik tedavinin başarısı ve tekrar kanama oranları

Background and Aims: Upper gastrointestinal system bleeding is an important and sometimes mortal situation. For endoscopic treatment of non-variceal upper gastrointestinal bleeding, some methods, such as injection treatment, thermal coagulation, argon plasma coagulation, and endoscopic clipping, can be used. In this study, we evaluated the relation between the endoscopic treatment modality for upper gastrointestinal bleeding and the re-bleeding rates. Materials and Methods: Patients who underwent gastrointestinal endoscopy for bleeding over a one-year period were included in the study. Results: We performed upper gastrointestinal endoscopy in a total of 5451 patients, and endoscopy was performed for upper gastrointestinal bleeding in 305 of them. In 68 of 305 patients (22.2%), there was active non-variceal bleeding. Among those patients, 38 of 68 (55.8%) had duodenal ulcer, 23 (33.8%) gastric ulcer, and 7 (10.2%) erosive gastrobulbopathy. Twenty-eight of 38 duodenal ulcer patients (73.6%) and 13 of 23 gastric ulcer patients (56.5%) had only injection treatment. Ten patients in each group (duodenal/gastric ulcer; 26.3% and 43.4%, respectively) received combined endoscopic therapy (injection treatment + thermal coagulation or injection treatment + argon plasma coagulation). In the monotherapy group, re-bleeding occurred in 4 of 28 duodenal ulcer patients (14.2%) and in 1 of 13 gastric ulcer patients (7.6%). In the combined therapy group, there was no re-bleeding in duodenal ulcer patients, but re-bleeding occurred in 2 of 10 patients (20%) with gastric ulcer. Conclusions:We believe that combined endoscopic therapy for upper gastrointestinal bleeding is more effective than monotherapy, especially in duodenal ulcer.