Endoscopic hemostasis of bleeding of the upper gastrointestinal tract by local injection of ninety-eight per cent dehydrated ethanol.

Abstract

Endoscopic dehydrated ethanol injection was attempted in 48 patients with substantial bleeding of the upper gastrointestinal tract; most of the patients had associated serious medical conditions. The causes of bleeding were: gastric ulcer in 17; duodenal ulcer in 11; gastric or duodenal vascular ectasias, or both, in five; Mallory-Weiss tear in three; acute gastric mucosal lesion in six; esophageal ulcer in two; marginal ulcer in two; gastric leiomyoma in one, and carcinoma of the stomach in one. The mean age was 57 years old (a range of 18 to 91 years old). The mean amount of blood loss prior to time of injection was 4.5 units (a range of 3 to 10 units). Ethanol injection was initially successful in 45 of 48 patients but rebleeding occurred within 72 hours in three of these patients. All instances of treated vascular ectasia disappeared by the time of follow-up endoscopy. No complications were attributable to the injections. Endoscopic local ethanol injection may be the treatment of choice in selected patients with bleeding of the upper gastrointestinal tract.