Document Detail


Current managements and outcomes of peptic and artificial ulcer bleeding in Japan.
MedLine Citation:
PMID:  20590780     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The recent trend of gastroduodenal ulcer bleeding in Japan has not been elucidated in detail and the data for a new categorized type, artificial ulcer bleeding, is completely lacking. The purpose of this paper is to elucidate current managements and outcomes of peptic and artificial ulcer bleeding in Japan. A retrospective multicenter study of consecutive case series was carried out during one year at nine departments of high-volume hospitals in Japan. The study included 325 consecutive patients (239 with peptic ulcers and 86 with artificial ulcers) with bleeding nonmalignant gastroduodenal ulcers that were revealed by emergency endoscopy between January 2008 and December 2008. Hemostasis was carried out mainly using endoscopic treatments. Rates of successful initial hemostasis, rebleeding, transfer to surgery, and death were recorded according to peptic and artificial ulcer bleeding. Additionally, preferred endoscopic methods, concomitant use of antisecretory drugs, and timing of second-look endoscopy were also measured. A total of 227 (99.1%) of 229 peptic ulcer patients with endoscopic treatment and all (100%) 84 artificial ulcer patients underwent successful tentative hemostasis. Rebleeding occurred in 23 peptic ulcer patients (10.1%) and 10 artificial ulcer patients (11.9%). One peptic ulcer patient and two artificial ulcer patients had final surgical rescue due to rebleeding. No death was observed. Monotherapy was predominant (around 65% of cases) in both types of ulcers. The coagulation forceps method was more frequently applied in artificial ulcers (P < 0.05). A per oral proton pump inhibitor was more frequently used in artificial ulcers (P < 0.05), although an intravenous proton pump inhibitor was used in the majority of patients in both types of ulcers. The frequency of second-look endoscopy in peptic ulcers (88%) was significantly higher than that in artificial ulcers (71%) (P < 0.05). There seemed to be no rule as to the timing of second-look endoscopy, although it was most frequently performed on the day after hemostasis. The recent outcomes of endoscopic treatment for nonmalignant gastroduodenal bleeding in Japan were excellent in both peptic and artificial ulcers with similar efficacies. Although they were minor findings, some differences in applied endoscopic methods, concomitant use of antisecretory drugs, and presence of second-look endoscopy were observed.
Authors:
Mitsuhiro Fujishiro; Nobutsugu Abe; Masaki Endo; Yoshiro Kawahara; Ryo Shimoda; Shinji Nagata; Kiyoaki Homma; Yoshinori Morita; Noriya Uedo
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society     Volume:  22 Suppl 1     ISSN:  1443-1661     ISO Abbreviation:  Dig Endosc     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9101419     Medline TA:  Dig Endosc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  S9-14     Citation Subset:  IM    
Affiliation:
Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Duodenal Ulcer*
Female
Follow-Up Studies
Hemostasis, Endoscopic / methods*
Humans
Incidence
Injections, Intravenous
Japan / epidemiology
Male
Middle Aged
Peptic Ulcer Hemorrhage / epidemiology,  therapy*
Proton Pump Inhibitors / administration & dosage*
Recurrence
Retrospective Studies
Stomach Ulcer*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Proton Pump Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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