Endoscopy pp 8-14 | Cite as

Endoscopic Injection Therapy of Gastroduodenal Ulcer Hemorrhage: A Randomized Comparison of Fibrin Sealant vs. Polidocanol

  • R. Salm
  • K. E. Grund
  • J. Sontheimer
  • A. Bustos
  • E. Weber
Conference paper
Part of the Fibrin Sealing in Surgical and Nonsurgical Fields book series (ADMERE, volume 8)


In a randomized trial involving 56 patients with acute gastroduodenal ulcer hemorrhage we examined the rebleeding rate after endoscopic local injection of fibrin sealant (group A, n = 30) in comparison to polidocanol (group B, n = 26). Included were ulcers with spurting (Forrest Ia) or oozing bleeding (F lb) or a visible vessel (F IIa). In case of F Ia/Ib the endoscopic therapy in both groups was combined with a preliminary injection of epinephrine (1:104). After endoscopic hemostasis the patients were transferred to the surgical intensive care unit. The patients underwent routine endoscopy 24 h later. If rebleeding signs occurred, emergency endoscopy was performed. In the case of rebleeding or a still visible vessel another injection therapy now with fibrin sealant in both groups was performed. Initial hemostasis was achieved in 100% of cases in group A and in 77% in group B (p ≤ 0.05). Recurrent hemorrhage occurred in 10% in group A and in 38% in group B (p ≤ 0.05). Permanent hemostasis was achieved in 93% in group A and 88% in group B. There were no differences between the two groups in the requirement for emergency surgery or mortality. A tendency toward a lower blood transfusion requirement was observed in group A, but it failed to achieve statistical significance. No complications of injection therapy were noted.


Fibrin Sealant Surgical Intensive Care Unit Injection Therapy Recurrent Hemorrhage Ulcer Hemorrhage 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • R. Salm
  • K. E. Grund
  • J. Sontheimer
  • A. Bustos
  • E. Weber

There are no affiliations available

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