A randomized comparison of multipolar electrocoagulation and injection sclerosis for the treatment of bleeding peptic ulcer

Several options are available to the gastroenterologist for the endoscopic control of peptic ulcer hemorrhage. Sixty men (mean age, 62 years) were stratified into those with actively bleeding ulcers or ulcers with stigmata of recent hemorrhage, and then randomized to treatment with injection sclerosis or the multipolar probe until bleeding ceased. There were no significant differences between the randomized groups in terms of age, ulcer size, or transfusion requirements. We achieved hemostasis in 95% of all patients. Re-bleeding rates were 25% and 23% in patients treated with the multipolar probe and injection sclerosis, respectively. There was no significant difference in mortality (14% multipolar probe, 7% injection sclerosis). Patients over the age of 70, those whose onset of bleeding was while an inpatient, and those with an ulcer larger than 2 cm were more likely to have a poor outcome, regardless of the type of endoscopic therapy. Injection sclerosis and multipolar electrocoagulation are equally effective in controlling bleeding from peptic ulcer.