This Week In The Bmj

Heat probe helps in managing gastric ulcers with spurting haemorrhage

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7090.0b (Published 03 May 1997) Cite this as: BMJ 1997;314:b

Endoscopic injection of adrenaline stops haemorrhage in peptic ulcer disease, but rebleeding occurs in 15-20% of patients. In a randomised controlled trial of 276 patients with actively bleeding ulcers, Chung et al (p 1307) compared the use of adrenaline alone with adrenaline injection followed by heat probe tamponade to improve haemostasis. Outcome as measured by initial endoscopic haemostasis, rebleeding, need for surgery, need for blood transfusion, length of stay, ulcer healing, and mortality in hospital did not differ between the groups. In those with spurting haemorrhage, however, the dual treatment significantly reduced requirement for surgery and length of stay. The authors recommend dual treatment in such patients, even if bleeding is initially controlled by adrenaline injection.