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Japanese

Nonsurgical Treatment of Gastroduodenal Bleeding : Choice of Appropriate Hemostatic Method and Its Effectiveness Hideyuki Fusanurto 1 , Takenobu Kamada 1 1The First Department of Internal Medicine, Osaka University, School of Medicine pp.377-384
Published Date 1989/4/25
DOI https://doi.org/10.11477/mf.1403106429
  • Abstract
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 An appropriate therapeutic method for controlling of gastroduodenal bleeding was studied in 377 patients. The initial treatment modality for the bleeding from hemorrhagic gastritis and peptic ulcer without protruded vessel was medical, which included H2-receptor antagonist, muscarine receptor antagonist, intensive antacid, secretin and others. Projectile bleeding and oozing from peptic ulcer with protruded vessel had to be controlled by endoscopical methods such as electrocautery, laser cautery, heater probe, mechanical clips and ethanol injection. None of these techniques, however, was completely satisfactory. Situations in which effectiveness of these techniques was limited included bleeding from peptic ulcer with protruded vessel over 2 mm in diameter, duodenal ulcer with marked deformity and postbulbar ulcer. Transcatheter arterial embolization was effective in cases with massive bleeding in which bleeding source was difficult to identify endoscopically as well as in cases with recurrent massive bleeding episodes of unknown origin. Nonsurgical procedures to control gastroduodenal bleeding made a significant contribution to the treatment of such complicated cases as sepsis, disseminated intravascular coagulation, renal and liver failure in which appropriate management of these complications per se were mandatory.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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