Korean J Gastrointest Endosc > Volume 37(1); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;37(1): 20-24.
위궤양출혈 환자에서 내시경적 고장성 식염수-에피네프린 용액 국소 주입법 후 유발된 위점막 괴사 1예
포항성모병원 내과
A Case of Mucosal Necrosis of the Stomach after Endoscopic Injection Therapy with Hypertonic Saline-Epinephrine (HS-E) for a Bleeding Peptic Ulcer with an Exposed Vessel
Do Hwae Park, M.D., Sun Taek Choi, M.D., Min Jae Cho, M.D., Jung Hyun Ryu, M.D. and Dong Wok Lee, M.D.
Department of Internal Medicine, Pohang St. Mary's Hospital, Pohang, Korea
Peptic ulcer bleeding is a frequent cause of upper G-I bleeding. Endoscopic injection therapy with hypertonic saline-epinephrine (HS-E) is a cost-effective and widely used therapy for hemostasis; however, 1∼3% of patients experience bleeding or perforation. A 70 year-old male patient was admitted with melena and hematemesis. An endoscopy on admission showed the presence of a 1 cm- sized well-demarcated ulcer with pulsatile bleeding at the lesser curvature of the distal antrum. Approximately 28 mL of HS-E solution was injected around the exposed vessel. Follow-up endoscopy performed 7 days later showed the presence of a 2 cm-sized newly developed mucosa necrosis at the lesser curvature of the pyloric channel, which was caused by ischemic necrosis of the gastric mucosa after HS-E injection. Endoscopic injection therapy with HS-E solution is a relatively safe technique, but mucosa necrosis can occur with the use of a dose of HS-E that is considered safe. We report a case of gastric mucosa necrosis following endoscopic HS-E injection therapy of a bleeding peptic ulcer. (Korean J Gastrointest Endosc 2008;37:20-24)
Key Words: Endoscopic injection therapy, Peptic ulcer bleeding, Hypertonic Saline-Epinephrine
주요어: 내시경적 국소 주입법, 소화성 궤양 출혈, 고장성 식염수-에피네프린 용액
PDF Links  PDF Links
Full text via DOI  Full text via DOI
Download Citation  Download Citation
Related article
Comparison of Hemostatic Efficacy between Epinephrine Injection Alone and a Combined Therapy with Hemoclip for Bleeding Peptic Ulcers  2006 January;32(1)
Editorial Office
Korean Society of Gastrointestinal Endoscopy
#817, 156 Yanghwa-ro (LG Palace, Donggyo-dong), Mapo-gu, Seoul, 04050, Korea
TEL: +82-2-335-1552   FAX: +82-2-335-2690    E-mail: CE@gie.or.kr
Copyright © Korean Society of Gastrointestinal Endoscopy.                 Developed in M2PI
Close layer