Endoscopic hemostasis with metallic hemoclips for iatrogenic Mallory-Weiss tear caused by endoscopic examination.

Abstract

AIM:

Applied endoscopic techniques including mucosal resection, sclerotherapy and endoscopic retrograde cholangiopancreatography (ERCP) have been advanced and iatrogenic complications including Mallory-Weiss tear (MWT) occasionally occur in daily endoscopic procedures. The present study aimed to examine the advantages of clipping for MWT complications that occur during endoscopic examination.

METHODS:

Over 10 years, we experienced 47 patients with bleeding caused by MWT. Metallic hemoclips were applied for 38 patients for hemostasis. These patients were categorized into two groups: 18 patients in group A whose bleeding tear occurred during endoscopic examination in an iatrogenic condition, and 20 patients in group B visited the emergency unit due to other etiology of MWT.

RESULTS:

The background characteristics, including length of tears, were not different between the two groups. Initial hemostasis was 100% in groups A and B. Rebleeding was 0/18 (0%) in group A and 1/20 (5 %) in group B. Number of patients who received blood transfusion was significantly higher in group B (group A: 0/18, group B: 4/20). Hemoglobin level before hemostasis was 12.5 g/dL in group A which was not different to that in group B, 10.9 g/dL.

CONCLUSION:

Application of hemoclips was effective for bleeding MWT during endoscopic procedures, which warranted prophylactic application of hemoclips on MWT during endoscopic examination.

• Authors: Ryo Shimoda, Ryuichi Iwakiri, Hiroyuki Sakata, Shinichi Ogata, Hibiki Ootani, Yasuhisa Sakata, Takehiro Fujise, Kanako Yamaguchi, Kotaro Mannen, Seichiro Arima, Ryosuke Shiraishi, Takahiro Noda, Akihiro Ono, Seiji Tsunada, Kazuma Fujimoto
• Journal: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (Dig Endosc) Vol. 21 Issue 1 Pg. 20-3 (Jan 2009) ISSN: 1443-1661 [Electronic] Australia
• PMID: 19691796 (Publication Type: Journal Article)

Topics

• Aged
• Endoscopy, Digestive System (adverse effects)
• Female
• Gastrointestinal Hemorrhage (etiology, therapy)
• Hemostasis, Surgical
• Humans
• Iatrogenic Disease
• Male
• Mallory-Weiss Syndrome (etiology, therapy)
• Middle Aged
• Surgical Instruments
• Treatment Outcome