Document Detail

Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers.
MedLine Citation:
PMID:  9158465     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare endoscopic adrenaline injection alone and adrenaline injection plus heat probe for the treatment of actively bleeding peptic ulcers. DESIGN: Randomised prospective study of patients admitted with actively bleeding peptic ulcers. SETTING: One university hospital. SUBJECTS: 276 patients with actively bleeding ulcers detected by endoscopy within 24 hours of admission: 136 patients were randomised to endoscopic adrenaline injection alone and 140 to adrenaline injection plus heat probe treatment. MAIN OUTCOME MEASURES: Initial endoscopic haemostasis; clinical rebleeding; requirement for operation; requirement for blood transfusion; hospital stay, ulcer healing at four weeks; and mortality in hospital. RESULTS: Initial haemostasis was achieved in 131/134 patients (98%) who received adrenaline injection alone and 135/136 patients (99%) who received additional heat probe treatment (P = 0.33). Outcome as measured by clinical rebleeding (12 v 5), requirement for emergency operation (14 v 8), blood transfusion (2 v 3 units), hospital stay (4 v 4 days), ulcer healing at four weeks (79.1% v 74%), and in hospital mortality (7 v 8) were not significantly different in the two groups. In the subgroup of patients with spurting haemorrhage 8/27 (29.6%; 14.5% to 50.3%) patients from the adrenaline injection alone group and 2/31 (6.5%; 1.1% to 22.9%) patients from the dual treatment group required operative intervention. The relative risk of this was lower in the dual treatment group (0.17; 0.03 to 0.87). Hospital stay was significantly shorter in the dual treatment group than the adrenaline injection alone group (4 v 6 days, P = 0.01). CONCLUSION: The addition of heat probe treatment after endoscopic adrenaline injection confers an advantage in ulcers with spurting haemorrhage.
S S Chung; J Y Lau; J J Sung; A C Chan; C W Lai; E K Ng; F K Chan; M Y Yung; A K Li
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  314     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-09     Completed Date:  1997-06-09     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1307-11     Citation Subset:  AIM; IM    
Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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MeSH Terms
Aged, 80 and over
Duodenal Ulcer / complications*,  drug therapy,  therapy
Endoscopy, Gastrointestinal
Epinephrine / administration & dosage*
Hospital Mortality
Hyperthermia, Induced / instrumentation*
Length of Stay
Middle Aged
Peptic Ulcer Hemorrhage / drug therapy,  therapy*
Prospective Studies
Stomach Ulcer / complications*,  drug therapy,  therapy
Treatment Outcome
Reg. No./Substance:
Comment In:
BMJ. 1997 Oct 18;315(7114):1016   [PMID:  9365313 ]

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