Author/Editor		Gorenšek, Milan
Title		Vpliv odstranjevanja krvnega strdka na učinkovitost kombiniranega injekcijskega zdravljenja
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1997
Volume		str. 95
Language		slo
Abstract		Background. The aim of the study was to change the conservative approach to peptic ulcer related bleeding by introducing an original injection method as a new endoscopic concept in the treatment of bleeding peptic ulcers. The main objective of the research work was to confirm the correctness of our hypothesis that adherent clots need to be removed before a combined injection sclerotherapy (IS) is carried out. The approach that was considered original in 1985 consisted of the following: immediate urgent endoscopy, non-selective performance of IS (incl. massive bleedings inespective of bleeding intensity, patient's condition, site and size of ulcer), adherent clot removal, prophylactic IS, repeated IS in recurrent bleedings, distribution and analysis of patients according to the newly proposed modification of Fonest classification (F Ic and F IIc). Methods and patients. Hemostasis induced by injection method is achieved through compression of the bleeding vessel by submucous infiltration of diluted adrenaline which also exerts a vasoconstriction effect, while obliteration of the bleeding vessel is achieved by injecting 1 % polidocanol (etoxisclerol) immediately next to the vein or directly into it. The method is simple and economically acceptable for wide use. In the seven year period (June 1985 - June 1992) of our prospedive controlled study,1342 patients with bleeding classified as FI and FII were subjected to emergency gastroscopy prior to their formal admission to hospital. In 19 patients (1.4%) the source of bleeding could not be found, and therefore those patients were not included into the analysis. While 117 patients formed a control group, other 125 were included into the study group. (Abstracts truncated at 2000 character)
Descriptors		PEPTIC ULCER HEMORRHAGE EPINEPHRINE SCLEROTHERAPY GASTROSCOPY SCLEROSING SOLUTIONS TREATMENT OUTCOME