Endoscopic sphincterotomy-induced hemorrhage: Treatment with multipolar electrocoagulation

Stuart Sherman, R. H. Hawes, R. Nisi, Glen Lehman

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Multipolar electrocoagulation is an effective therapy for patients with endoscopic evidence of active upper gastrointestinal hemorrhage or a non- bleeding visible vessel in an ulcer crater. The use of this therapy for endoscopic sphincterotomy-induced hemorrhage has not been reported previously. This prospective study attempted to assess the efficacy of multipolar electrocoagulation in patients with endoscopic sphincterotomy- induced hemorrhage not responding to conservative and/or other endoscopic measures. Nine patients with moderate or severe bleeding following endoscopic sphincterotomy (one, immediate; eight, delayed 12 to 144 hours) were treated by multipolar electrocoagulation. Prior to endoscopic therapy with multipolar electrocoagulation, the mean hematocrit drop was 14.5% and the mean number of packed red blood cells transfused was 4.8 units. Complete hemostasis was achieved in eight (89%) patients. Re-bleeding occurred in two (25%) and was controlled by a second course of multipolar electrocoagulation in one in whom it was attempted. There were no complications or deaths from multipolar electrocoagulation and surgical therapy was avoided in all nine patients. We recommend proceeding with multipolar electrocoagulation (if possible) after injection therapy and/or balloon tamponade fail to control the hemorrhage and before considering angiographic or surgical intervention.

Original languageEnglish (US)
Pages (from-to)123-126
Number of pages4
JournalGastrointestinal Endoscopy
Volume38
Issue number2
StatePublished - 1992

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Endoscopic Sphincterotomy
Electrocoagulation
Hemorrhage
Therapeutics
Balloon Occlusion
Gastrointestinal Hemorrhage
Hemostasis
Hematocrit
Ulcer
Erythrocytes
Prospective Studies
Injections

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic sphincterotomy-induced hemorrhage : Treatment with multipolar electrocoagulation. / Sherman, Stuart; Hawes, R. H.; Nisi, R.; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 38, No. 2, 1992, p. 123-126.

Research output: Contribution to journalArticle

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AB - Multipolar electrocoagulation is an effective therapy for patients with endoscopic evidence of active upper gastrointestinal hemorrhage or a non- bleeding visible vessel in an ulcer crater. The use of this therapy for endoscopic sphincterotomy-induced hemorrhage has not been reported previously. This prospective study attempted to assess the efficacy of multipolar electrocoagulation in patients with endoscopic sphincterotomy- induced hemorrhage not responding to conservative and/or other endoscopic measures. Nine patients with moderate or severe bleeding following endoscopic sphincterotomy (one, immediate; eight, delayed 12 to 144 hours) were treated by multipolar electrocoagulation. Prior to endoscopic therapy with multipolar electrocoagulation, the mean hematocrit drop was 14.5% and the mean number of packed red blood cells transfused was 4.8 units. Complete hemostasis was achieved in eight (89%) patients. Re-bleeding occurred in two (25%) and was controlled by a second course of multipolar electrocoagulation in one in whom it was attempted. There were no complications or deaths from multipolar electrocoagulation and surgical therapy was avoided in all nine patients. We recommend proceeding with multipolar electrocoagulation (if possible) after injection therapy and/or balloon tamponade fail to control the hemorrhage and before considering angiographic or surgical intervention.

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