[Endoscopic hemostasis in stomach and duodenum].

Abstract

Endoscopic hemostasis in cases of acute upper gastrointestinal bleeding may be achieved by various methods with comparable initial results, nevertheless the frequency of re-bleeding is different in regard to the techniques. The frequency of re-bleeding may be reduced by the application of fibrin tissue sealant, the eradication of Helicobacter pylori and by daily endoscopic controls. The use of big channel endoscopes makes intragastral survey easier, and beyond that endoscopic doppler-ultrasound may reveal visible and not visible arterial vessels on the bottom of the ulceration, so indicating the greater risk of re-bleeding. The progress of endoscopic hemostasis combined with specific pharmaco-therapy is on the way to relieve laparotomy in favour of intraluminal minimal invasive techniques in a larger scale.