SELECTIONS AND TECHNIQUES OF ENDOSCOPIC HEMOSTATIC PROCEDURES FOR VARIOUS HEMORRHAGIC LESIONS IN THE UPPER GASTROINTESTINAL TRACT

概要

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Gastrointestinal (GI) bleeding is an emergency condition that we often encounter in ordinary practice. Endoscopic hemostatic procedures for hemorrhagic lesions in the GI tract are classified into four groups as follows : 1. chemical spraying such as epinephrine or thrombin, 2. mechanical ligation such as endocrip, 3. local injection of medicine such as absolute ethanol or hypersaline-epinephrine, and 4. cauterization using high frequent current or heater probe. These procedures have advantages and disadvantages respectively, therefore it is important to select a suitable procedure according to bleeding status and a kind of lesions. We should have two or more favorite endoscopic hemostatic procedures. When we perform emergency endoscopy for a patient with GI bleeding, we should grasp enough about his general condition, complications, and medical history. Furthermore, informed consent and infection control are essential. Getting suitable endoscopic view is a key point for successful endoscopic hemostasis, and choice of scope or using cap that is fitted on the top of scope are useful to achieve that. If we could not control GI bleeding in spite of performing endoscopic hemostatic procedures, we should consider about surgical treatment or interventional radiology without being too late.
社団法人日本消化器内視鏡学会の論文