scholarly journals Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Istvan Rácz ◽  
Milan Szalai ◽  
Nora Dancs ◽  
Tibor Kárász ◽  
Andrea Szabó ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastroduodenal Ulcer ◽  
Saline Group ◽  
Saline Infusion ◽  
Active Bleeding ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Acute Ulcer ◽  
Gastroduodenal Ulcer Bleeding ◽  
Bleeding Ulcers

The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD) durations of5.45±12.9hours and6.9±13.2hours, respectively (P=0.29). Actively bleeding ulcers were detected in 46/240 (19.2%) of cases in the pantoprazole group as compared with 23/93 (24.7%) in the saline infusion group (P=0.26). Different durations of pantoprazole infusion (0–4 hours,>4 hours, and>6 hours) had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02andP=0.04). Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

scholarly journals Determination of the Risk of Recurrent Gastroduodenal Ulcer Bleeding

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
I. I. Dutka ◽  
F. V. Grynchuk
Keyword(s):  
Gastroduodenal Ulcer ◽  
Blood Type ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Recurrent Ulcer ◽  
Type B ◽  
Gastroduodenal Ulcer Bleeding ◽  
Type Ab ◽  
Bleeding Ulcers

Despite the advances in endoscopic haemostasis, the incidence of recurrent ulcer bleeding remains to be high. It necessitates further search for its prognosis and methods of treatment.The objective of the research was to analyse risk factors for recurrent gastroduodenal ulcer bleeding.Materials and methods. The study included 203 patients with gastroduodenal ulcer bleeding. There were 135 (66.5%) males and 68 (33.3%) females. All the patients were examined and received conservative treatment according to treatment protocols.Results. Duodenal ulcer was diagnosed in 127 (62.3%) patients, gastric ulcer was found in 68 (33.3%) patients, gastroduodenal ulcer was seen in 9 (4.4%) patients. The recurrence of bleeding was observed in 24 (11.8%) cases. Most cases of recurrent bleeding (n=11 (45.8%) occurred within 2-3 days after the admission. 9 (37.5%) patients developed the recurrence of bleeding later. The lowest number of recurrent bleeding occurred within the first day - 4 (16.7%) cases. The incidence of recurrent bleeding was higher in men rather than in women - 17 (70.8%). Recurrent bleeding was observed in 9 (64.29%) patients with blood type O; 4 (28.57%) patients with blood type A; 1 (7.14%) patient with blood type B; 1 (7.14%) patient with blood type AB. The majority of recurrences (n=15 (62.5%) occurred in patients without ulcer in anamnesis. There was found no clear connection between ulcer location and the rate of recurrent bleeding.Conclusions.The scales of predicting recurrent bleeding that are known today do not consider a number of important clinical and pathogenetic factors as a basis of recurrence.The improvement of the results of treating bleeding ulcers is possible only on the basis of the complex of factors determining the effectiveness of regeneration.

scholarly journals The original scale prediction of recurrence risk of gastroduodenal ulcer bleeding

2021 ◽  
pp. 72-78
Author(s):  
I. V. Melnyk ◽  
S. B. Soliev
Keyword(s):  
Duodenal Ulcer ◽  
Gastroduodenal Ulcer ◽  
Recurrence Risk ◽  
Gastric Ulcers ◽  
Ulcer Bleeding ◽  
Duodenal Ulcers ◽  
Results Of Treatment ◽  
Research Goal ◽  
Gastroduodenal Ulcer Bleeding

Research goal - to examine the effectiveness of active-individualized tactics in treatment of chronic gastric and duodenal ulcers. Material and methods. Analysis of treatment of 251 patients with chronic gastric and duodenal ulcer bleeding was conducted. Duodenal ulcer bleeding was present in 202 cases (80,5%), gastric ulcers were the reason of bleeding in 49 cases (19,5%). Treatment conducted according to principles of active-individualized tactics. Results. The provided characteristics and the acquired results were presented according to the fundamental components of active-individualized tactics in treatment of gastric and duodenal ulcers. Diagnostic and treatment abilities of endoscopy were determined, an unique scale of bleeding relapse risk was presented, the time limits and main indications for surgery were explained,, the role of bleeding relapse was emphasized as crucial in forming the main results of treatment of patients with bleeding gastric and duodenal ulcers. Conclusion. At present time, active-individualized tactics should be used for treatment of gastric and duodenal ulcer bleeding.

scholarly journals 322 – Prevention of Recurrent Idiopathic Gastroduodenal Ulcer Bleeding: A 2-Year Double-Blind Randomized Trial (NRT STUDY)

2019 ◽  
Vol 156 (6) ◽  
pp. S-62-S-63
Author(s):  
Louis Ho Shing Lau ◽  
Jessica Y. Ching ◽  
Yee Kit Tse ◽  
Rachel Ling ◽  
Francis K. Chan ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Double Blind ◽  
Gastroduodenal Ulcer Bleeding

Endoscopic Doppler Sonography in gastroduodenal ulcer bleeding

1992 ◽  
Vol 70 (8) ◽  
Author(s):  
D. Jaspersen ◽  
T. K�rner ◽  
J. Wzatek ◽  
W. Schorr ◽  
C.B. Gaster ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Gastroduodenal Ulcer Bleeding

Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial

Gut ◽  
2019 ◽  
Vol 69 (4) ◽  
pp. 652-657 ◽  
Author(s):  
Grace L H Wong ◽  
Louis H S Lau ◽  
Jessica Y L Ching ◽  
Yee-Kit Tse ◽  
Rachel H Y Ling ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Randomised Trial ◽  
Ulcer Bleeding ◽  
Recurrent Ulcer ◽  
Gi Bleeding ◽  
Double Blind ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
History Of ◽  
Bleeding Ulcers

ObjectivePatients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have a considerable risk of recurrent ulcer complications. We hypothesised that a proton pump inhibitor (lansoprazole) is superior to a histamine 2 receptor antagonist (famotidine) for the prevention of recurrent ulcer bleeding in such patients.DesignIn this industry-independent, double-blind, randomised trial, we recruited patients with a history of idiopathic bleeding ulcers. After ulcer healing, we randomly assigned (1:1) patients to receive oral lansoprazole 30 mg or famotidine 40 mg daily for 24 months. The primary endpoint was recurrent upper GI bleeding within 24 months, analysed in the intention-to-treat population as determined by an independent adjudication committee.ResultsBetween 2010 and 2018, we enrolled 228 patients (114 patients in each study group). Recurrent upper GI bleeding occurred in one patient receiving lansoprazole (duodenal ulcer) and three receiving famotidine (two gastric ulcers and one duodenal ulcer). The cumulative incidence of recurrent upper GI bleeding in 24 months was 0.88% (95% CI 0.08% to 4.37%) in the lansoprazole arm and 2.63% (95% CI 0.71% to 6.91%) in the famotidine arm (p=0.313; crude HR 0.33, 95% CI 0.03 to 3.16, p=0.336). None of the patients who rebled used aspirin, non-steroidal anti-inflammatory drugs or other antithrombotic drugs.ConclusionThis 2-year, double-blind randomised trial showed that among patients with a history of H. pylori-negative idiopathic ulcer bleeding, recurrent bleeding rates were comparable between users of lansoprazole and famotidine, although a small difference in efficacy cannot be excluded.Trial registration numberNCT01180179; Results.

scholarly journals Surgical treatment of gastroduodenal ulcer bleeding: Our experience

2007 ◽  
Vol 54 (1) ◽  
pp. 165-167
Author(s):  
S.N. Krstic ◽  
T. Alempijevic ◽  
M.N. Krstic ◽  
Z.D. Lausevic ◽  
A. Sijacki ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Gastroduodenal Ulcer ◽  
Treatment Options ◽  
Ulcer Bleeding ◽  
Endoscopic Management ◽  
Ulcer Disease ◽  
Endoscopic Techniques ◽  
Clinical Center ◽  
The Mean ◽  
Gastroduodenal Ulcer Bleeding

Introduction: Acute bleeding from the upper gastrointestinal tract remains the commonest emergency in gastroenterology, and is most often caused by gastroduodenal ulcer disease. Despite introduction of novel endoscopic techniques and pharmacological treatment, 6-15% patients have to be operated. The aim of our investigation is analyze data of patients treated for gastrointestinal ulcer bleeding in our institution, their treatment options and outcome. Patients and methods: We included 2237 patients admitted in the Department for Emergency medicine of Clinical center of Serbia during the period from January 1999 until December 2003. because of gastroduodenal ulcer bleeding. We analyzed age, gender treatment option, hospital stay and mortality. Results: The mean age of our patients was 61.58 years, 1346 male and 891 female. The majority of patients were conservatively treated (84.5%). Operated patients mostly undergo Billroth II resection (57.8%). The mean hospital stay was 7.3 days. Average mortality was 14.4% Conclusions: Despite adequate endoscopic management of bleeding gastroduodenal ulcer, surgeons will continue to treat this patients for emergency surgery.

scholarly journals APPLICATION OF MODERN METHODS OF ENDOSCOPIC HАEMOSTASIS IN THE TREATMENT OF GASTRODUODENAL ULCER BLEEDING

2021 ◽  
pp. 81-84
Author(s):  
N. M. Honcharova ◽  
P. V. Svirepo ◽  
A. S. Honcharov
Keyword(s):  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Modern Methods ◽  
Anesthetic Risk ◽  
Gastroduodenal Ulcer Bleeding ◽  
Endoscopic Clipping ◽  
Submucosal Infiltration

Summary. The aim of the study is to improve the results of treatment of patients with ulcerative gastroduodenal bleeding by using the methods of endoscopic hаemostasis. Materials and research methods. The results of endoscopic hаemostasis of 153 patients who were treated in the surgical department of the “Regional Clinical Hospital” were analyzed. Patients were examined clinically, laboratory and instrumental. Results and its discussion. For Forrest 1a, b bleeding, endoscopic clipping was used in 16 (10.4 %) patients with a visualized vessel in the bottom of the ulcer. In the studied patients of this group, there were no relapses of bleeding. Diathermy coagulation was used in 42 (27.5 %) patients. Recurrent bleeding was observed in 6 patients. Submucosal infiltration was performed in 37 (24.2 %) patients with ulcerative bleeding. Repeated bleeding was recorded in 9 patients within the next 3 hours after the intervention and in 7 patients during the first days after endoscopic hаemostasis. Combinations of endoscopic methods of hаemostasis were used in 58 (37.9 %) patients. Conclusions. The use of modern methods of endoscopic hаemostasis followed by adequate pharmacotherapy in most cases allows achieving a final stop of bleeding. Patients with a high risk of recurrent bleeding and a low surgical and anesthetic risk after successful endoscopic hаemostasis are shown surgical intervention before the development of recurrent bleeding.

The value of routine second-look endoscopy in the management of the acute gastroduodenal ulcer bleeding

2009 ◽  
Vol 150 (42) ◽  
pp. 1932-1936 ◽  
Author(s):  
Katalin Szőcs ◽  
Tibor Kárász ◽  
Hussam Saleh ◽  
Andrea Szabó ◽  
Mihály Csöndes ◽  
...  
Keyword(s):  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Second Look ◽  
Gastroduodenal Ulcer Bleeding

A tervezett ellenőrző endoszkópiák szerepe az akut gastroduodenalis fekélyvérző betegek ellátásában mindmáig ellentmondásos. Endoszkópos és klinikai adatokra alapozott rizikócsoport meghatározására van szükség ahhoz, hogy kiválaszthatóak legyenek azok a betegek, akiknél a tervezett ellenőrző endoszkópia stratégiája hasznosnak bizonyulhat. Célkitűzés: A tervezett ellenőrző endoszkópiák klinikai hasznát kívántuk felmérni akut gastroduodenalis fekélyvérző betegeink klinikai és endoszkópos adatainak retrospektív elemzésével. Módszer: Összesen 274 fekélyvérző beteg adatait elemeztük. A tervezett ellenőrző endoszkópiák hatékonyságának lemérésére az újbóli endoszkópos vérzéscsillapító beavatkozások szükségességét használtuk fel. A betegeket a sürgősségi endoszkópia során észlelt Forrest szerinti fekélystádium alapján csoportosítottuk. Eredmények: Az aktívan vérző fekélybetegek (Forrest Ia, Ib) csoportjában a tervezett endoszkópiák alkalmával 23,8%-ban végeztünk újbóli endoszkópos vérzéscsillapítást. Az ércsonkos fekélyesek (Forrest IIa) csoportjában 13,0%-ban, míg a thrombussal fedett fekélyesek (Forrest IIb) körében 13,3%-ban volt szükség újabb endoszkópos hemosztatikus kezelésre az ellenőrző endoszkópiák kapcsán. Bár a beavatkozások gyakorisága közötti különbségek statisztikailag nem szignifikánsak, mégis klinikailag számottevőnek tartható az, hogy az eredetileg aktívan vérző betegek negyedében hasznos volt a tervezett ellenőrző endoszkópia. Következtetés: Az eredmények arra engednek következtetni, hogy a tervezett ellenőrző endoszkópia stratégiája a kezdetben aktívan vérző és nagy újravérzési kockázatú betegek számára kedvezőbb kórlefolyást ígér.

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