scholarly journals Endoscopic Cyanoacrylate Injection Treatment for Refractory High-risk Peptic Ulcer Bleeding by Conventional Endoscopic Therapy

2022 ◽  
Author(s):  
Biguang Tuo ◽  
Haijun Mou ◽  
Cheng Zou ◽  
Guoqing Shi ◽  
Sheng Wu ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
High Risk ◽  
Endoscopic Therapy ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Intravascular Injection ◽  
Injection Treatment ◽  
Life Threatening ◽  
Rebleeding Rate ◽  
Hemostatic Therapy

Abstract Bleeding is a major and potentially life-threatening complication of peptic ulcer. Despite endoscopic hemostatic therapy advance, conventional endoscopic hemostatic modalities remain refractory for peptic ulcer bleeding with big size, fibrous base or in difficult-to-access anatomical locations. In this study, we attempted to evaluate the efficacy and safety of endoscopic cyanoacrylate injection treatment (ECIT) for refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy. The patients with refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy were carried out ECIT. The data were retrospectively collected. A total of 119 patients accepted ECIT. 74 patients (62.18%) obtained successful intravascular injection and perivascular injection was performed in 45 patients (37.82%). Immediate hemostatic rate for active bleeding achieved 90.91%. Rebleeding rate within 30 days was 12.07%. Overall successful hemostasis rate achieved 87.93%. Immediate hemostatic rate and overall successful hemostasis rate in intravascular injection patients were markedly superior over perivascular injection. Rebleeding rate in intravascular injection patients was markedly lower than that in perivascular injection patients. 11 patients complicated abdominal pain and no other complication occurred. In conclusion, ECIT, especial intravascular injection, was effective and safe, with high successful hemostasis rate for refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy.

Will Helicobacter Pylori Affect Short-Term Rebleeding Rate in Peptic Ulcer Bleeding Patients After Successful Endoscopic Therapy?

1999 ◽  
Vol 94 (11) ◽  
pp. 3184-3188 ◽  
Author(s):  
Hwai-Jeng Lin ◽  
Guan-Ying Tseng ◽  
Yu-Hsi Hsieh ◽  
Chin-Lin Perng ◽  
Fa-Yauh Lee ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Endoscopic Therapy ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Short Term ◽  
Rebleeding Rate

UPDATE ON ENDOSCOPIC MANAGEMENT OF PEPTIC ULCER BLEEDING

2012 ◽  
pp. 5-11
Author(s):  
Ngoc Quy Hue Dang ◽  
Van Huy Tran
Keyword(s):  
Peptic Ulcer ◽  
High Risk ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Endoscopic Therapy ◽  
Active Bleeding ◽  
Ulcer Bleeding ◽  
Endoscopic Management ◽  
High Dose ◽  
Peptic Ulcer Bleeding

Peptic ulcer bleeding is a common medical emergency and still a potentially fatal condition. It is the best managed using a multidisciplinary approach by a team with medical, endoscopic and surgical expertise. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of presentation. Endoscopic therapy is indicated for patients with high-risk stigmata, in particular those with active bleeding and visible vessels. A combination of proton pump inhibitors and endoscopic therapy (using a combination of injection and mechanical hemostasis) offers the best chance of hemostasis for those with active bleeding ulcers. The application of an ulcer-covering hemospray is a new promising tool. High dose proton pump inhibitors should be administered intravenously for 72 h in high-risk patients. Helicobacter pylori should be tested for in all patients with peptic ulcer bleeding and eradicated if positive

EFFICACY OF INITIAL AND PERMANENT HEMOSTASIS OF THE ENDOSCOPIC HEMOCLIP METHOD COMBINED WITH HIGH-DOSE INFUSION OF PROTON PUMP INHIBITOR IN PATIENTS WITH PEPTIC ULER BLEEDING

2018 ◽  
pp. 15-21
Author(s):  
Hieu Tam Huynh ◽  
Dang Quy Dung Ho
Keyword(s):  
Peptic Ulcer ◽  
Success Rate ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
Injection Sclerotherapy ◽  
High Dose ◽  
Peptic Ulcers ◽  
Peptic Ulcer Bleeding ◽  
Bleeding Peptic Ulcers ◽  
Hemostatic Therapy

Background: Peptic ulcer bleeding is one of the common medical emergencies. The hemostatic efficacy of endoscopic therapeutic modalities has been reported in many studies and frequently has been found to exceed 90%. Four groups of modalities are used in the endoscopic management of bleeding peptic ulcers: thermal probe methods, injection sclerotherapy, local spray methods, and mechanical hemostatic therapy. The endoscopic hemoclip method is a safe and effective hemostatic therapy for managing bleeding peptic ulcers. Objective: To determine the success rate of hemoclip in endoscopic hemostasis. Patients and methods: Clinical intervention study on 36 patients with peptic ulcer bleeding admitted in Can Tho Central General Hospital from May 2012 to November 2014. All the patients underwent emergency endoscopy for hemostasis by hemoclip and high-dose PPI use. Results: The success rate of initial hemostasis was 97.2%, and permanent hemostasis was 91.7%. The rates of rebleeding, surgery, mortality were 11.1%, 5.6%, 2.8%, respectively. Conclusion: Endoscopic hemostasis therapy by clipping combined with high- dose PPI is an effective, relatively safe treatment for peptic ulcer bleeding. Key words: Peptic ulcer bleeding, hemoclip, endoscopic hemostasis therapy

scholarly journals Performance Comparison of the Deep Learning and the Human Endoscopist for Bleeding Peptic Ulcer Disease

2021 ◽  
Author(s):  
Hsu-Heng Yen ◽  
Ping-Yu Wu ◽  
Pei-Yuan Su ◽  
Chia-Wei Yang ◽  
Yang-Yuan Chen ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Endoscopic Therapy ◽  
Learning Model ◽  
Ulcer Bleeding ◽  
Learning Models ◽  
Peptic Ulcer Bleeding ◽  
Ulcer Disease ◽  
Deep Learning Model

Abstract Purpose Management of peptic ulcer bleeding is clinically challenging. Accurate characterization of the bleeding during endoscopy is key for endoscopic therapy. This study aimed to assess whether a deep learning model can aid in the classification of bleeding peptic ulcer disease. Methods Endoscopic still images of patients (n = 1694) with peptic ulcer bleeding for the last 5 years were retrieved and reviewed. Overall, 2289 images were collected for deep learning model training, and 449 images were validated for the performance test. Two expert endoscopists classified the images into different classes based on their appearance. Four deep learning models, including Mobile Net V2, VGG16, Inception V4, and ResNet50, were proposed and pre-trained by ImageNet with the established convolutional neural network algorithm. A comparison of the endoscopists and trained deep learning model was performed to evaluate the model’s performance on a dataset of 449 testing images. Results The results first presented the performance comparisons of four deep learning models. The Mobile Net V2 presented the optimal performance of the proposal models. The Mobile Net V2 was chosen for further comparing the performance with the diagnostic results obtained by one senior and one novice endoscopists. The sensitivity and specificity were acceptable for the prediction of “normal” lesions in both 3-class and 4-class classifications. For the 3-class category, the sensitivity and specificity were 94.83% and 92.36%, respectively. For the 4-class category, the sensitivity and specificity were 95.40% and 92.70%, respectively. The interobserver agreement of the testing dataset of the model was moderate to substantial with the senior endoscopist. The accuracy of the determination of endoscopic therapy required and high-risk endoscopic therapy of the deep learning model was higher than that of the novice endoscopist. Conclusions In this study, the deep learning model performed better than inexperienced endoscopists. Further improvement of the model may aid in clinical decision-making during clinical practice, especially for trainee endoscopist.

231 Flat Spots in Peptic Ulcer Bleeding (PUB's) - Some Have a High Risk of Rebleeding

2011 ◽  
Vol 73 (4) ◽  
pp. AB119
Author(s):  
Dennis M. Jensen ◽  
Thomas O. Kovacs ◽  
Gordon V. Ohning ◽  
Rome Jutabha ◽  
Kevin A. Ghassemi ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
High Risk ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding

scholarly journals Clinical Outcomes of the Marginal Ulcer Bleeding after Gastrectomy: As Compared to the Peptic Ulcer Bleeding with Nonoperated Stomach

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Woo Chul Chung ◽  
Eun Jung Jeon ◽  
Kang-Moon Lee ◽  
Chang Nyol Paik ◽  
You Suk Oh ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Outcomes ◽  
Marginal Ulcer ◽  
Ulcer Bleeding ◽  
Consecutive Series ◽  
Peptic Ulcer Bleeding ◽  
Positive Rate ◽  
Rebleeding Rate ◽  
H Pylori ◽  
Upper Gastrointestinal

Background. Marginal ulcer is a well-known complication after gastrectomy. Its bleeding can be severe, but the severity has rarely been reported. We aim to evaluate the clinical outcomes of marginal ulcer bleeding (MUB) as compared to peptic ulcer bleeding (PUB) with nonoperated stomach.Methods. A consecutive series of patients who had nonvariceal upper gastrointestinal bleeding and admitted to the hospital between 2005 and 2011 were retrospectively analyzed. A total of 530 patients were enrolled in this study, and we compared the clinical characteristics between 70 patients with MUB and 460 patients with PUB.Results. Patients with MUB were older (mean age:62.86±10.59years versus53.33±16.68years,P=0.01). The initial hemoglobin was lower (8.16±3.05 g/dL versus9.38±2.49 g/dL,P=0.01), and the duration of admission was longer in MUB (7.14±4.10days versus5.90±2.97days,P=0.03). After initial hemostasis, the rebleeding rate during admission was higher (16.2% versus 6.5%,P=0.01) in MUB. However, the mortality rate did not differ statistically between MUB and PUB groups.Helicobacter pylori-positive rate with MUB was lower than that of PUB (19.4% versus 54.4%,P=0.01).Conclusions. Clinically, MUB after gastrectomy is more severe than PUB with nonoperated stomach. Infection withH. pylorimight not appear to play an important role in MUB after gastrectomy.

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