Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy
Abstract We report here on our experience of clinically relevant bleeding after endoscopic sphincterotomy (ES). Relevant bleeding was defined by the occurrence of (a) hematemesis or melena and (b) at least a two-point drop in hemoglobin, with no other bleeding source on endoscopy. These two criteria...
Gespeichert in:
| Veröffentlicht in: | Endoscopy 1994-02, Vol.26 (2), p.217-221 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 221 |
|---|---|
| container_issue | 2 |
| container_start_page | 217 |
| container_title | Endoscopy |
| container_volume | 26 |
| creator | Boujaoudé, J. Pelletier, G. Fritsch, J. Choury, A. Lefebvre, J. F. Roche, A. Frouge, C. Liguory, C. Etienne, J. P. |
| description | Abstract
We report here on our experience of clinically relevant bleeding after endoscopic sphincterotomy (ES). Relevant bleeding was defined by the occurrence of (a) hematemesis or melena and (b) at least a two-point drop in hemoglobin, with no other bleeding source on endoscopy. These two criteria were met in 16 patients between 1983 and 1992. They represented 0.65 % of all ES procedures performed during this period. Bleeding occurred immediately after ES in five cases, and was delayed in 11 cases from one to eight days (mean two days). Patients were retrospectively classified into three groups according to the severity of bleeding and subsequent clinical management. In six cases (group 1), bleeding developed slowly without shock and stopped spontaneously. In five cases (group 2), bleeding developed rapidly with melena and a drop in hemoglobin, but without shock. These patients were successfully managed with sclerotherapy without any further complications. The five patients in Group 3 had brisk bleeding with hematemesis and shock. Endoscopic hemostasis could not be performed; emergency arteriography disclosed active bleeding in four patients, and embolization of the gastroduodenal artery was performed. Bleeding stopped in all patients. Billroth II anastomosis appeared to be the only factor associated with an increased risk of clinically relevant bleeding. It was possible to control bleeding following ES using endoscopic or angiographic hemostasis, surgery being avoided in all cases. |
| doi_str_mv | 10.1055/s-2007-1008946 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_76580302</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>76580302</sourcerecordid><originalsourceid>FETCH-LOGICAL-c452t-da6cf95dd6cae553fe60896ccc625462042f5153b2804500139e51713d5131563</originalsourceid><addsrcrecordid>eNp1kMtPxCAQh4nR6Pq4ejPpwXirDlBo96ib9ZH4SHwk3ghS6rKhsEKr2f9emm28eRqG-fgx-RA6xnCOgbGLmBOAMscA1bTgW2iCC1rlVYXJNpoAYJqXhL_vof0Yl0MLwHbRbgWEU15N0OODdPJTt9p1mW-ymTXOKGntOnvWVn_LdH1lta6N-8yuvbX-ZzjNXe2j8iujspfVwjjV6eA7364P0U4jbdRHYz1Ab9fz19ltfv90cze7vM9VwUiX15KrZsrqmiupGaON5ml9rpTihBWcQEEahhn9IBUUbFh7qhkuMa0ZpphxeoDONrmr4L96HTvRmqi0tdJp30dRclYBBZLA8w2ogo8x6EasgmllWAsMYhAoohgEilFgenAyJvcfra7_8NFYmp-OcxmTqCZIp0z8wwooSyBFwvIN1i1MsiuWvg8uGfnv219yYoUd</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76580302</pqid></control><display><type>article</type><title>Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy</title><source>MEDLINE</source><source>Thieme Connect Journals</source><creator>Boujaoudé, J. ; Pelletier, G. ; Fritsch, J. ; Choury, A. ; Lefebvre, J. F. ; Roche, A. ; Frouge, C. ; Liguory, C. ; Etienne, J. P.</creator><creatorcontrib>Boujaoudé, J. ; Pelletier, G. ; Fritsch, J. ; Choury, A. ; Lefebvre, J. F. ; Roche, A. ; Frouge, C. ; Liguory, C. ; Etienne, J. P.</creatorcontrib><description>Abstract
We report here on our experience of clinically relevant bleeding after endoscopic sphincterotomy (ES). Relevant bleeding was defined by the occurrence of (a) hematemesis or melena and (b) at least a two-point drop in hemoglobin, with no other bleeding source on endoscopy. These two criteria were met in 16 patients between 1983 and 1992. They represented 0.65 % of all ES procedures performed during this period. Bleeding occurred immediately after ES in five cases, and was delayed in 11 cases from one to eight days (mean two days). Patients were retrospectively classified into three groups according to the severity of bleeding and subsequent clinical management. In six cases (group 1), bleeding developed slowly without shock and stopped spontaneously. In five cases (group 2), bleeding developed rapidly with melena and a drop in hemoglobin, but without shock. These patients were successfully managed with sclerotherapy without any further complications. The five patients in Group 3 had brisk bleeding with hematemesis and shock. Endoscopic hemostasis could not be performed; emergency arteriography disclosed active bleeding in four patients, and embolization of the gastroduodenal artery was performed. Bleeding stopped in all patients. Billroth II anastomosis appeared to be the only factor associated with an increased risk of clinically relevant bleeding. It was possible to control bleeding following ES using endoscopic or angiographic hemostasis, surgery being avoided in all cases.</description><identifier>ISSN: 0013-726X</identifier><identifier>EISSN: 1438-8812</identifier><identifier>DOI: 10.1055/s-2007-1008946</identifier><identifier>PMID: 8026368</identifier><identifier>CODEN: ENDCAM</identifier><language>eng</language><publisher>Stuttgart: Thieme</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; Biological and medical sciences ; Blood Loss, Surgical - prevention & control ; Common Bile Duct - pathology ; Common Bile Duct - surgery ; Constriction, Pathologic - surgery ; Diseases of the digestive system ; Embolization, Therapeutic ; Female ; Gallstones - surgery ; Hematemesis - etiology ; Hemoglobins - analysis ; Hemostasis, Surgical - methods ; Humans ; Incidence ; Male ; Medical sciences ; Middle Aged ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Recurrence ; Remission, Spontaneous ; Retrospective Studies ; Risk Factors ; Sclerotherapy ; Shock - etiology ; Shock - therapy ; Sphincterotomy, Endoscopic - adverse effects ; Time Factors</subject><ispartof>Endoscopy, 1994-02, Vol.26 (2), p.217-221</ispartof><rights>Georg Thieme Verlag KG Stuttgart · New York</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-da6cf95dd6cae553fe60896ccc625462042f5153b2804500139e51713d5131563</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-2007-1008946.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><link.rule.ids>314,776,780,3004,3005,27901,27902,54534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4077024$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8026368$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boujaoudé, J.</creatorcontrib><creatorcontrib>Pelletier, G.</creatorcontrib><creatorcontrib>Fritsch, J.</creatorcontrib><creatorcontrib>Choury, A.</creatorcontrib><creatorcontrib>Lefebvre, J. F.</creatorcontrib><creatorcontrib>Roche, A.</creatorcontrib><creatorcontrib>Frouge, C.</creatorcontrib><creatorcontrib>Liguory, C.</creatorcontrib><creatorcontrib>Etienne, J. P.</creatorcontrib><title>Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy</title><title>Endoscopy</title><addtitle>Endoscopy</addtitle><description>Abstract
We report here on our experience of clinically relevant bleeding after endoscopic sphincterotomy (ES). Relevant bleeding was defined by the occurrence of (a) hematemesis or melena and (b) at least a two-point drop in hemoglobin, with no other bleeding source on endoscopy. These two criteria were met in 16 patients between 1983 and 1992. They represented 0.65 % of all ES procedures performed during this period. Bleeding occurred immediately after ES in five cases, and was delayed in 11 cases from one to eight days (mean two days). Patients were retrospectively classified into three groups according to the severity of bleeding and subsequent clinical management. In six cases (group 1), bleeding developed slowly without shock and stopped spontaneously. In five cases (group 2), bleeding developed rapidly with melena and a drop in hemoglobin, but without shock. These patients were successfully managed with sclerotherapy without any further complications. The five patients in Group 3 had brisk bleeding with hematemesis and shock. Endoscopic hemostasis could not be performed; emergency arteriography disclosed active bleeding in four patients, and embolization of the gastroduodenal artery was performed. Bleeding stopped in all patients. Billroth II anastomosis appeared to be the only factor associated with an increased risk of clinically relevant bleeding. It was possible to control bleeding following ES using endoscopic or angiographic hemostasis, surgery being avoided in all cases.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Surgical</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical - prevention & control</subject><subject>Common Bile Duct - pathology</subject><subject>Common Bile Duct - surgery</subject><subject>Constriction, Pathologic - surgery</subject><subject>Diseases of the digestive system</subject><subject>Embolization, Therapeutic</subject><subject>Female</subject><subject>Gallstones - surgery</subject><subject>Hematemesis - etiology</subject><subject>Hemoglobins - analysis</subject><subject>Hemostasis, Surgical - methods</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Recurrence</subject><subject>Remission, Spontaneous</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sclerotherapy</subject><subject>Shock - etiology</subject><subject>Shock - therapy</subject><subject>Sphincterotomy, Endoscopic - adverse effects</subject><subject>Time Factors</subject><issn>0013-726X</issn><issn>1438-8812</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtPxCAQh4nR6Pq4ejPpwXirDlBo96ib9ZH4SHwk3ghS6rKhsEKr2f9emm28eRqG-fgx-RA6xnCOgbGLmBOAMscA1bTgW2iCC1rlVYXJNpoAYJqXhL_vof0Yl0MLwHbRbgWEU15N0OODdPJTt9p1mW-ymTXOKGntOnvWVn_LdH1lta6N-8yuvbX-ZzjNXe2j8iujspfVwjjV6eA7364P0U4jbdRHYz1Ab9fz19ltfv90cze7vM9VwUiX15KrZsrqmiupGaON5ml9rpTihBWcQEEahhn9IBUUbFh7qhkuMa0ZpphxeoDONrmr4L96HTvRmqi0tdJp30dRclYBBZLA8w2ogo8x6EasgmllWAsMYhAoohgEilFgenAyJvcfra7_8NFYmp-OcxmTqCZIp0z8wwooSyBFwvIN1i1MsiuWvg8uGfnv219yYoUd</recordid><startdate>19940201</startdate><enddate>19940201</enddate><creator>Boujaoudé, J.</creator><creator>Pelletier, G.</creator><creator>Fritsch, J.</creator><creator>Choury, A.</creator><creator>Lefebvre, J. F.</creator><creator>Roche, A.</creator><creator>Frouge, C.</creator><creator>Liguory, C.</creator><creator>Etienne, J. P.</creator><general>Thieme</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19940201</creationdate><title>Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy</title><author>Boujaoudé, J. ; Pelletier, G. ; Fritsch, J. ; Choury, A. ; Lefebvre, J. F. ; Roche, A. ; Frouge, C. ; Liguory, C. ; Etienne, J. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-da6cf95dd6cae553fe60896ccc625462042f5153b2804500139e51713d5131563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis, Surgical</topic><topic>Biological and medical sciences</topic><topic>Blood Loss, Surgical - prevention & control</topic><topic>Common Bile Duct - pathology</topic><topic>Common Bile Duct - surgery</topic><topic>Constriction, Pathologic - surgery</topic><topic>Diseases of the digestive system</topic><topic>Embolization, Therapeutic</topic><topic>Female</topic><topic>Gallstones - surgery</topic><topic>Hematemesis - etiology</topic><topic>Hemoglobins - analysis</topic><topic>Hemostasis, Surgical - methods</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Recurrence</topic><topic>Remission, Spontaneous</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sclerotherapy</topic><topic>Shock - etiology</topic><topic>Shock - therapy</topic><topic>Sphincterotomy, Endoscopic - adverse effects</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boujaoudé, J.</creatorcontrib><creatorcontrib>Pelletier, G.</creatorcontrib><creatorcontrib>Fritsch, J.</creatorcontrib><creatorcontrib>Choury, A.</creatorcontrib><creatorcontrib>Lefebvre, J. F.</creatorcontrib><creatorcontrib>Roche, A.</creatorcontrib><creatorcontrib>Frouge, C.</creatorcontrib><creatorcontrib>Liguory, C.</creatorcontrib><creatorcontrib>Etienne, J. P.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boujaoudé, J.</au><au>Pelletier, G.</au><au>Fritsch, J.</au><au>Choury, A.</au><au>Lefebvre, J. F.</au><au>Roche, A.</au><au>Frouge, C.</au><au>Liguory, C.</au><au>Etienne, J. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy</atitle><jtitle>Endoscopy</jtitle><addtitle>Endoscopy</addtitle><date>1994-02-01</date><risdate>1994</risdate><volume>26</volume><issue>2</issue><spage>217</spage><epage>221</epage><pages>217-221</pages><issn>0013-726X</issn><eissn>1438-8812</eissn><coden>ENDCAM</coden><abstract>Abstract
We report here on our experience of clinically relevant bleeding after endoscopic sphincterotomy (ES). Relevant bleeding was defined by the occurrence of (a) hematemesis or melena and (b) at least a two-point drop in hemoglobin, with no other bleeding source on endoscopy. These two criteria were met in 16 patients between 1983 and 1992. They represented 0.65 % of all ES procedures performed during this period. Bleeding occurred immediately after ES in five cases, and was delayed in 11 cases from one to eight days (mean two days). Patients were retrospectively classified into three groups according to the severity of bleeding and subsequent clinical management. In six cases (group 1), bleeding developed slowly without shock and stopped spontaneously. In five cases (group 2), bleeding developed rapidly with melena and a drop in hemoglobin, but without shock. These patients were successfully managed with sclerotherapy without any further complications. The five patients in Group 3 had brisk bleeding with hematemesis and shock. Endoscopic hemostasis could not be performed; emergency arteriography disclosed active bleeding in four patients, and embolization of the gastroduodenal artery was performed. Bleeding stopped in all patients. Billroth II anastomosis appeared to be the only factor associated with an increased risk of clinically relevant bleeding. It was possible to control bleeding following ES using endoscopic or angiographic hemostasis, surgery being avoided in all cases.</abstract><cop>Stuttgart</cop><cop>New York, NY</cop><pub>Thieme</pub><pmid>8026368</pmid><doi>10.1055/s-2007-1008946</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0013-726X |
| ispartof | Endoscopy, 1994-02, Vol.26 (2), p.217-221 |
| issn | 0013-726X 1438-8812 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_76580302 |
| source | MEDLINE; Thieme Connect Journals |
| subjects | Adult Aged Aged, 80 and over Anastomosis, Surgical Biological and medical sciences Blood Loss, Surgical - prevention & control Common Bile Duct - pathology Common Bile Duct - surgery Constriction, Pathologic - surgery Diseases of the digestive system Embolization, Therapeutic Female Gallstones - surgery Hematemesis - etiology Hemoglobins - analysis Hemostasis, Surgical - methods Humans Incidence Male Medical sciences Middle Aged Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Remission, Spontaneous Retrospective Studies Risk Factors Sclerotherapy Shock - etiology Shock - therapy Sphincterotomy, Endoscopic - adverse effects Time Factors |
| title | Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T08%3A49%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Management%20of%20Clinically%20Relevant%20Bleeding%20Following%20Endoscopic%20Sphincterotomy&rft.jtitle=Endoscopy&rft.au=Boujaoud%C3%A9,%20J.&rft.date=1994-02-01&rft.volume=26&rft.issue=2&rft.spage=217&rft.epage=221&rft.pages=217-221&rft.issn=0013-726X&rft.eissn=1438-8812&rft.coden=ENDCAM&rft_id=info:doi/10.1055/s-2007-1008946&rft_dat=%3Cproquest_cross%3E76580302%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=76580302&rft_id=info:pmid/8026368&rfr_iscdi=true |