Endoscopic injection treatment in patients with shock and gastrointestinal bleeding or stigmata of recent hemorrhage

Forty cases of upper gastrointestinal bleeding were studied. Twenty-three patients had shock and active bleeding (3 spurting, 12 oozing and 2 a clot with oozing) or stigmata of recent hemorrhage (4 with a clot and 2 with a visible vessel). Nineteen of these were submitted to endoscopic injection. In 4 cases with multiple acute hemorrhagic lesions and shock, and in 17 patients with stigmata of recent bleeding without shock, the technique was not carried out. None of the patients had a rebleed. One patient was submitted to surgery 24 hours after injection for a large acute gastric ulcer in the process of perforating, and died of pulmonary embolism 4 days later. No technique-related complications were observed. We believe endoscopic injection treatment might be the technique of choice in patients with shock and active bleeding or stigmata of recent hemorrhage of the upper gastrointestinal tract.