| Abstract: | In the upper gastrointestinal tract endoscopic hemostasis has not replaced surgery, but reduced it to a necessary minimum. Active bleeding can be stanched by the injection method during emergency endoscopy. For bleeding esophageal varices we use polidocanol, in other lesions in the upper gastrointestinal tract we apply thrombin and in the lower intestinal tract adrenalin. If endoscopic hemostasis is successful in small bleeding vessels, the efficiency of hemostatic injections can be trusted. Large visible vessels need to be operated early electively. After the introduction of this therapeutic concept, for example the operation frequency in bleeding gastroduodenal ulcers could be reduced from 51% in 1982 to 28% in 1988. Mortality was improved from 22.1% to 4.7%. In gastrointestinal bleeding diagnostic problems occur especially with angio dysplasia in the small intestine and colon. This is due to impaired accessibility in the small intestine and problematic cleaning of the colon. In the intestine surgical therapy of bleeding lesions has very few alternatives, for example palliative embolization of infusion of vasoconstrictiva. |
