Endoscopic bipolar electrocoagulation in massive upper gastrointestinal bleeding

Endoscopic bipolar electrocoagulation in upper gastrointestinal bleeding

A total of 213 cases of upper gastrointestinal bleeding treated by bipolar electrocoagulation (BPEC) were reviewed and its efficacy in the management of massive bleeding was evaluated. Initial hemostasis was achieved by BPEC in 97.6% cases with an overall rebleeding rate of 17.1%. The majority of rebleeding occurred in patients with acute mucosal lesions who had serious underlying medical problems. There were no complications related to the procedure. Endoscopic BPEC safely arrested oozing to spurting bleeding and contributed greatly to the control of upper gastrointestinal bleeding.

Acute gastrointestinal bleeding--a common problem revisited

Acute gastrointestinal bleeding, a common problem, becomes a serious situation in the 15% of afflicted patients in whom the bleeding does not stop spontaneously. The typical high-risk patient is elderly, has multisystem disease, has a hemorrhagic episode during hospitalization for other disorders, or is an outpatient with severe bleeding of short duration and symptoms of volume depletion. Endoscopy can be performed to identify the active site of hemorrhage and is associated with an overall diagnostic accuracy that exceeds 90% in patients with upper gastrointestinal bleeding. The rate and character of observed bleeding have substantial predictive value for continued bleeding. The mortality among high-risk patients with bleeding in either the upper or the lower gastrointestinal tract ranges from 17 to 44%. Therefore, an organized aggressive approach to management of acute gastrointestinal bleeding is necessary.