HÜSEYİN KÖSEOĞLU, Fatma Ebru AKIN, Aylin BOLAT DEMİREZER, TEVFİK SOLAKOĞLU, Roni ATALAY, Sevil SARI ÖZER, Eyüp SELVİ, Öykü YÜREKLİ TAYFUR, Naciye Şemnur BÜYÜKAŞIK, Osman ERSOY

Varis dışı üst gastrointestinal sistem kanamalı hastalarda endoskopik klip uygulamalarımız

Giriş ve Amaç: Endoskopik klip uygulaması üst gastrointestinal sistem kanaması tedavisinde yaygın olarak kullanılmaktadır. Kanayan peptik ülser, Dieulafoy lezyonu ve Mallory-Weiss yırtığında klip ile kanama kontrolünün sağlanabileceği gösterilmiştir. Biz bu çalışmada kliniğimi- zin üst gastrointestinal sistem kanamasında endoskopik klip uygulama verilerini değerlendirdik. Gereç ve Yöntem: Üst gastrointestinal sistem kanaması nedeniyle yatırılan ve endoskopik klip uygulanan 27 hasta retrospektif olarak incelendi. Klip uygulama nedenleri, tekrar kanama sıklığı, eritrosit süspansiyon ihtiyaçları, mortalite sıklığı, Rockall skoru ve Glasgow-Blatchford skoru değerlendirildi. Bulgular: Çalışmaya dahil edilen hastaların 17si erkek, 10u kadın idi ve yaş ortalaması 58,7 yıl olarak hesaplandı. Klip uygulanan 5 hastada gastrik ülser (1 hasta For- rest 1a, 2 hasta Forrest 1b, 2 hasta Forrest 2a); 10 hastada duodenal ülser (5 hasta Forrest 1b, 5 hasta Forrest 2a); 7 hastada Mallory-Weiss yırtığı ve 4 hastada Dieulafoy lezyonu üst gastrointestinal sistem ka- namasının nedeni idi. Hastalardan birinde ise hem Forrest 2a duode- num ülseri hem de Mallory-Weiss yırtığı mevcuttu. 27 hastanın 2sin- de (%7,4) işlem sonrası takip sırasında kanama tekrarladı. Hastaların 19unda (%70) eritrosit süspansyonu ihtiyacı oldu ve toplam 72 ünite ES verildi. Hastaların ortalama Rockall skoru 2,9 ve ortalama Glasgow-Blat- chford skoru 8,5 idi. Sonuç: Prognoz açısından riskli olan hastalarımızda mortalite saptanmamış ve tekrar kanama riski düşük bulunmuştur.

Endoscopic clipping for non-variceal upper gastrointestinal bleeding

Background and Aims: Endoscopic clipping has been widely used for upper gastrointestinal bleeding. It has been shown that hemostasis with endoscopic clipping is successful in bleeding peptic ulcers, Dieu - lafoys lesions, and Mallory-Weiss tears. The aim of this study was to evaluate the efficacy of endoscopic clipping in our endoscopy unit. Ma - terials and Methods: Patients presenting with upper gastrointestinal bleeding were evaluated retrospectively. Twenty-seven patients were treated with endoscopic clipping. The etiology of bleeding, rebleeding rates, need for packed red blood cell transfusion, mortality rate, and the Rockall and Glasgow-Blatchford scores were noted. Results: The mean age of the patients (17 male, 10 female) was 58,7 years. Five patients had gastric ulcer (1 Forrest 1a, 2 Forrest 1b, 2 Forrest 2a), 10 patients duodenal ulcer (5 Forrest 1b, 5 Forrest 2a), 7 patients Mallory- Weiss tears, and 4 patients Dieulafoys lesion as the etiology of upper gastrointestinal bleeding. One patient had Forrest 2a duodenal ulcer and Mallory-Weiss tears. Two of the patients (7,4%) rebled. Nineteen patients needed packed red blood cell transfusion with a total of 72 units. The mean Rockall score was 2,9 and the mean Glasgow-Blatch- ford score was 8,5. Conclusions: Although our patient population was high-risk, the rebleeding rate was low, and none of the patients died.

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