UPPER GASTROINTESTINAL BLEEDING:IS ONLY AN INJECTION OF EPINEPHRINE SUFFICIENT? SUCCES RATES BY FORREST CLASSIFICATION

Abstract

Objective: Endoscopic treatment is an effective and successful treatment for non-variceal upper gastrointestinal system (GIS) bleedings. In recent years, endoscopic combined therapies have been recommended for hemostasis. The aim of this study was to investigate primary hemostasis rates and re-bleeding rates obtained by epinephrine injection alone.Material and Methods: We analysed patients who had alone endoscopic epinephrine injection treatment for upper gastrointestinal system bleeding between January 2014 and January 2019. Gender, age, etiology of bleeding, Forrest classification, treatment efficacy and re-bleeding rates of the patients were recorded. The files of the patients were analyzed retrospectively. Results:The number of patients who met the study criteria was 107. There were 16 patients in Group 1 (Forrest 1a), 64 patients in Group 2 (Forrest 1b) and 27 patients in Group 3 (Forrest 2a). Primary hemostasis was achieved in 14 (87.5%) of 16 patients in Group 1, 62 (97%) of 64 in Group 2, and 27 (100%) of 27 Group 3. Re-bleeding rates were 4 (28%), 10 (16%), 2 (7%) in groups 1,2 and 3, respectively.Conclusion: It is thought that endoscopic combined treatment should be applied especially in patients with Forrest 1a and 1b bleeding ulcers, whereas in Forrest 2a ulcer patients, because of both the high rate of primary hemostasis and low rate of re-bleeding according to the results of the present study, the treatment of adrenalin injection alone can be used alone like other hemostasis modalities.

Keywords

• endoscopic treatment
• forrest classification
• upper gastrointestinal bleeding