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ENDOSCOPIC HEMOSTASIS WITH METALLIC HEMOCLIPS FOR IATROGENIC MALLORY‐WEISS TEAR CAUSED BY ENDOSCOPIC EXAMINATION
Author(s) -
Shimoda Ryo,
Iwakiri Ryuichi,
Sakata Hiroyuki,
Ogata Shinichi,
Ootani Hibiki,
Sakata Yasuhisa,
Fujise Takehiro,
Yamaguchi Kanako,
Mannen Kotaro,
Arima Seichiro,
Shiraishi Ryosuke,
Noda Takahiro,
Ono Akihiro,
Tsunada Seiji,
Fujimoto Kazuma
Publication year - 2009
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2008.00825.x
Subject(s) - medicine , mallory–weiss syndrome , hemostasis , surgery , endoscopic mucosal resection , endoscopy , group b , tears , etiology
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.