In the last 8 years period 369 patients with acute upper gastrointestinal
bleeding were admitted to the Department of Internal Medicine, District Hospital Siófok. All patients were treated by combined injection
sclerotherapy during the urgent endoscopy. The sclerotizing
solution contained at the first step
ethamsylate,
calcium gluconate, epinephrin,
hypertonic saline solution, and the second step 1%
aethoxysklerol. At he time of urgent endoscopy 77% of the patients had acute
bleeding (Forrest I.a., I.b.) and 23% of them showed stigmata of fresh
bleeding (Forrest II.a., II.b.). Primary
endoscopic hemostasis was achieved in all patients. In 7.9% of patients (n = 29) developed recurrent
bleeding during the observation period, who were resclerotized. Twenty of them (5.4%) were treated by elective surgery. No hemorrhagic or sclerotizing
therapy associated mortality occurred. Five out of 20 operated patients (1.4% of all sclerotized cases) had died due to the serious complications of their chronic
liver disease. Patients with succesful initial
endoscopic hemostasis were treated conservatively (
proton pump inhibitors, H-2 blockers,
antacids,
sucralfate,
lactulose) and underwent control endoscopy after 24 hours. Using this sclerotizing method in the treatment of acute upper gastrointestinal bleedings the number of acute surgery and mortality decreased significantly. It is supposed, that the locally administered
ethamsylate,
calcium gluconate, epinephrin,
hypertonic saline solution and
aethoxysklerol containing sklerotizing
solution might play a favorable role in the successful control of acute
bleeding ulcers.