Resumo

IZQUIERDO DE LA ROSA, Hipólito; VEGA MENDEZ, Juan Carlos  e  GARCIA BARRETO, Rosa María. Sclerotherapy in upper digestive non-varicose hemorrhage. AMC [online]. 2004, vol.8, n.5, pp. 48-60. ISSN 1025-0255.

A longitudinal and retrospective study was carried out with the aim of evaluating the results of the endoscopic sclerotherapy in the upper digestive hemorrhages in the service of Gastroenterology at Dr. Octavio de la Concepción y de la Pedraja Military Clinical-Surgical Hospital, of Camagüey city. The universe was carried composed of 1 880 patients to whom urgent endoscopies were performed from 1989 to 2002. Upper digestive hemorrhages non-varicose were diagnosed, 368 out of them presented active bleeding. Each patient completed a survey in which the following variables were included: age, sex, antecedents of ingestion of gastroerosives, time elapsed since the beginning og hemorrahage, bleeding manifestation in from of hematemesis, melene or both associated. Panendoscopio G 1F -1T- 30 was used with a needle of catheter of Olympus House, for injecting the sclerosing substance. Adrenaline 1x 10 000 in 37 % of patients was used and associated to Polycadonol 1 % in the remaining 63 %. Endoscopic scleroterapy was done to 368 patients with active bleeding, 267 (75, 25 %) out of them were men and 101 (27, 44 %) women, in ages among 15 and 95 years, occurred more frequently in the sixth decade of life. The 48 % was done in the first 12 h and the remaining in the 24 h after initiating bleeding. The 57 % of lesions were Forrest Ib type and the most frequent localization in duodenum. Melena was the most frequent clinical manifestation (57, 6 %). In the 93 % of patients success was obtained, there was failure in 26 patients (7 %), all received surgical treatment, four of them died (1 %). Nevertheless, the number of urgent interventions decreased, so the operatory mortality blood consumption and hospital cost were reduced. Concluding, endoscopic sclerotherapy of emergency through the injection of Adrenaline alone or associated to Polycadonol exerts a clearly favorable effect in the evolution of secondary digestive hemorrhages to ulcerous diseases of the upper digestive tract with signs of active bleeding at the moment of performing panendoscopy.

Palavras-chave : GASTROINTESTINAL HEMORRHAGE; SCLEROTHERAPY; ESOPHAGEAL AND GASTRIC VARICES; EPINEPHRINE [therapeutic use].

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