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Philippe Ducrotte - One of the best experts on this subject based on the ideXlab platform.

  • Syndrome de Mallory Weiss diagnostic et traitement
    Presse Medicale, 2010
    Co-Authors: S Lecleire, M Antonietti, Philippe Ducrotte
    Abstract:

    Mallory-Weiss Syndrome is relatively common and is involved in 3 to 10% of cases of upper gastrointestinal bleeding. Most of the time, the hemorrhage is mild and stops spontaneously. Clinical suspicion requires confirmation by an upper gastrointestinal endoscopy, which must be performed rapidly after the first hematemesis. Mallory-Weiss Syndrome is diagnosed when it shows a longitudinal mucosal tear at the esophagogastric junction. Patients with active bleeding or signs of recent bleeding at endoscopy need immediate endoscopic treatment for hemostasis. Band ligation seems to be the most efficient procedure for primary hemostasis and for preventing recurrent bleeding. The use of proton pump inhibitors and antiemetics seems logical in all cases, although nothing in the literature demonstrates their efficacy.

  • endoscopic band ligation could decrease recurrent bleeding in Mallory Weiss Syndrome as compared to haemostasis by hemoclips plus epinephrine
    Alimentary Pharmacology & Therapeutics, 2009
    Co-Authors: S Lecleire, M Antonietti, I Iwanickicaro, A Duclos, S Ramirez, E Ensoussa, S Herve, Philippe Ducrotte
    Abstract:

    BACKGROUND: Mallory-Weiss Syndrome (MWS) with active bleeding at endoscopy may require endoscopic haemostasis the modalities of which are not well-defined. AIM: To compare the efficacy of endoscopic band ligation vs. hemoclip plus epinephrine (adrenaline) in bleeding MWS. METHODS: From 2001 to 2008, 218 consecutive patients with a MWS at endoscopy were hospitalized in our Gastrointestinal Bleeding Unit. In 56 patients (26%), an endoscopic haemostasis was required because of active bleeding. Band ligation was performed in 29 patients (Banding group), while hemoclip application plus epinephrine injection was performed in 27 patients (HE 95% CI = 1.15-15.8) and active bleeding at endoscopy (OR = 1.9; 95% CI = 1.04-5.2) were independent predictive factors of early recurrent bleeding. CONCLUSIONS: Haemostasis by hemoclips plus epinephrine was an independent predictive factor of rebleeding. This result suggests that band ligation could be the first choice endoscopic treatment for bleeding MWS, but requires further prospective assessment.

  • endoscopic band ligation could decrease recurrent bleeding in Mallory Weiss Syndrome as compared to haemostasis by hemoclips plus epinephrine
    Alimentary Pharmacology & Therapeutics, 2009
    Co-Authors: S Lecleire, M Antonietti, A Duclos, S Ramirez, S Herve, I Iwanickicaron, E Bensoussan, Philippe Ducrotte
    Abstract:

    Summary Background  Mallory–Weiss Syndrome (MWS) with active bleeding at endoscopy may require endoscopic haemostasis the modalities of which are not well-defined. Aim  To compare the efficacy of endoscopic band ligation vs. hemoclip plus epinephrine (adrenaline) in bleeding MWS. Methods  From 2001 to 2008, 218 consecutive patients with a MWS at endoscopy were hospitalized in our Gastrointestinal Bleeding Unit. In 56 patients (26%), an endoscopic haemostasis was required because of active bleeding. Band ligation was performed in 29 patients (Banding group), while hemoclip application plus epinephrine injection was performed in 27 patients (H&E group). Treatment efficacy and early recurrent bleeding were retrospectively compared between the two groups. Results  Primary endoscopic haemostasis was achieved in all patients. Recurrent bleeding occurred in 0% in Banding group vs. 18% in HE 95% CI = 1.15–15.8) and active bleeding at endoscopy (OR = 1.9; 95% CI = 1.04–5.2) were independent predictive factors of early recurrent bleeding. Conclusions  Haemostasis by hemoclips plus epinephrine was an independent predictive factor of rebleeding. This result suggests that band ligation could be the first choice endoscopic treatment for bleeding MWS, but requires further prospective assessment.

Takashi Abe - One of the best experts on this subject based on the ideXlab platform.

  • endoscopic hemoclipping for upper gi bleeding due to Mallory Weiss Syndrome
    Gastrointestinal Endoscopy, 2001
    Co-Authors: Yasuharu Yamaguchi, Taro Yamato, Naoya Katsumi, Katsuro Morozumi, Takashi Abe, Hitoshi Ishida, Shinichi Takahashi
    Abstract:

    Abstract Background: Endoscopic hemoclipping is known to be highly effective as hemostatic treatment for upper gastrointestinal bleeding. However, the efficacy and safety of hemoclipping for Mallory-Weiss Syndrome (MWS) have not been reported. Thus, the aim of the present study was to assess prospectively the usefulness of endoscopic hemoclipping for MWS bleeding. Methods: This study was conducted from January 1994 to August 1999. Hemoclipping was performed when active bleeding (spurting, streaming or oozing), visible vessels or fresh adhesive clots were found on endoscopic examination. Patients who did not have any of these findings were conservatively treated. Follow-up endoscopy was performed within 24 hours, after 5 days and between 1 and 2 months after the procedure. Results: MWS was diagnosed in a total of 58 patients during the study. Hemoclipping was performed in 26 patients and was technically successful in all cases. The average number of hemoclips used was 2.8 ± 1.6 (range 1 to 8). The number of hemoclips required for hemostasis depended on the nature of the bleeding. No complications, recurrent bleeding, or deaths resulted. Follow-up endoscopy showed no evidence of hemoclip-induced tissue injury and no impairment of Mallory-Weiss tears. Conclusion: Endoscopic hemoclipping provided an effective and safe modality for obtaining hemostasis when bleeding is due to MWS. (Gastrointest Endosc 2001;53:427-30.)

  • 7142 endoscopic hemoclipping for upper gastrointestinal bleeding due to Mallory Weiss Syndrome
    Gastrointestinal Endoscopy, 2000
    Co-Authors: Yasuharu Yamaguchi, M Kimura, Taro Yamato, Naoya Katsumi, Katsuro Morozumi, Yasushi Morita, Miki Miura, Toshiyuki Hashimoto, Yoshikazu Yamaguchi, Takashi Abe
    Abstract:

    Aim: Endoscopic treatment with sclerotherapy or thermal methods has been widely used for upper gastrointestinal (UGI ) bleeding due to Mallory-Weiss Syndrome (MWS). However, the potential drawback of thermal methods and the injection of sclerosing agents is that these may cause excessive tissue injury leading to necrosis and perforation. Recently, endoscopic hemoclipping was shown to be highly effective for as a hemostatic treatment for UGI bleeding. Hemoclipping causes less damage to the surrounding area than sclerotherapy or thermal methods. However, the efficacy and safety of hemoclipping for MWS bleeding has not been reported. The aim of the present study was to assess prospectively the usefulness of endoscopic hemoclipping for MWS bleeding. Methods: This prospective study was performed over a 5 year period beginning in January 1994. When patients were diagnosed with MWS by endoscopy , hemoclipping was performed for patients with active bleeding , visible vessel and/or red clots (Group H). The remaining patients with old clots and linear tears in the Esophagogastric junctional (EGJ) mucosa as the only possible origin of bleeding were conservatively treated (Group C). The clinical data and outcome of endoscopic treatment were compared between these two groups. Results: A total of 58 patients underwent emergency endoscopy for UGI bleeding due to MWS from January 1994 to August 1999. During endoscopic examination, active bleeding was found in 17 patients (29%), a visible vessel in one patient (2%) and red clots in 8 patients (14%); Hemoclipping was performed on all 26 patients. Of the remaining 32 patients, 12 patients (21%) had old clots, and 20 (34%) had linear tears without stigmata of recent hemorrhage in the EGJ; these patients did not receive hemoclipping. Significantly more patients in Group H had shock and trasfusional requirements over 800ml than in Group C [the former 4 (17%) vs 0, the latter 4 (17%) vs 0]. The mean hemoglobin level on admission was significantly lower in Group H (10.6±2.9g/dl)than in Group C (12.2±3.0g/dl). Significantly more patients in Group H had critical concomitant diseases than in Group C [14 (54%) vs 8 (25%)]. However, all patients in Group H successfully underwent endoscopic hemostasis with no rebleeding. No patients in Conservative group had rebleeding. No complications related to the endoscopic procedures and no hospital deaths were found in either group. Conclusion : Endoscopic hemoclipping provided an effective and safe modality for securing hemostasis for MWS bleeding.

S Lecleire - One of the best experts on this subject based on the ideXlab platform.

  • Syndrome de Mallory Weiss diagnostic et traitement
    Presse Medicale, 2010
    Co-Authors: S Lecleire, M Antonietti, Philippe Ducrotte
    Abstract:

    Mallory-Weiss Syndrome is relatively common and is involved in 3 to 10% of cases of upper gastrointestinal bleeding. Most of the time, the hemorrhage is mild and stops spontaneously. Clinical suspicion requires confirmation by an upper gastrointestinal endoscopy, which must be performed rapidly after the first hematemesis. Mallory-Weiss Syndrome is diagnosed when it shows a longitudinal mucosal tear at the esophagogastric junction. Patients with active bleeding or signs of recent bleeding at endoscopy need immediate endoscopic treatment for hemostasis. Band ligation seems to be the most efficient procedure for primary hemostasis and for preventing recurrent bleeding. The use of proton pump inhibitors and antiemetics seems logical in all cases, although nothing in the literature demonstrates their efficacy.

  • endoscopic band ligation could decrease recurrent bleeding in Mallory Weiss Syndrome as compared to haemostasis by hemoclips plus epinephrine
    Alimentary Pharmacology & Therapeutics, 2009
    Co-Authors: S Lecleire, M Antonietti, I Iwanickicaro, A Duclos, S Ramirez, E Ensoussa, S Herve, Philippe Ducrotte
    Abstract:

    BACKGROUND: Mallory-Weiss Syndrome (MWS) with active bleeding at endoscopy may require endoscopic haemostasis the modalities of which are not well-defined. AIM: To compare the efficacy of endoscopic band ligation vs. hemoclip plus epinephrine (adrenaline) in bleeding MWS. METHODS: From 2001 to 2008, 218 consecutive patients with a MWS at endoscopy were hospitalized in our Gastrointestinal Bleeding Unit. In 56 patients (26%), an endoscopic haemostasis was required because of active bleeding. Band ligation was performed in 29 patients (Banding group), while hemoclip application plus epinephrine injection was performed in 27 patients (HE 95% CI = 1.15-15.8) and active bleeding at endoscopy (OR = 1.9; 95% CI = 1.04-5.2) were independent predictive factors of early recurrent bleeding. CONCLUSIONS: Haemostasis by hemoclips plus epinephrine was an independent predictive factor of rebleeding. This result suggests that band ligation could be the first choice endoscopic treatment for bleeding MWS, but requires further prospective assessment.

  • endoscopic band ligation could decrease recurrent bleeding in Mallory Weiss Syndrome as compared to haemostasis by hemoclips plus epinephrine
    Alimentary Pharmacology & Therapeutics, 2009
    Co-Authors: S Lecleire, M Antonietti, A Duclos, S Ramirez, S Herve, I Iwanickicaron, E Bensoussan, Philippe Ducrotte
    Abstract:

    Summary Background  Mallory–Weiss Syndrome (MWS) with active bleeding at endoscopy may require endoscopic haemostasis the modalities of which are not well-defined. Aim  To compare the efficacy of endoscopic band ligation vs. hemoclip plus epinephrine (adrenaline) in bleeding MWS. Methods  From 2001 to 2008, 218 consecutive patients with a MWS at endoscopy were hospitalized in our Gastrointestinal Bleeding Unit. In 56 patients (26%), an endoscopic haemostasis was required because of active bleeding. Band ligation was performed in 29 patients (Banding group), while hemoclip application plus epinephrine injection was performed in 27 patients (H&E group). Treatment efficacy and early recurrent bleeding were retrospectively compared between the two groups. Results  Primary endoscopic haemostasis was achieved in all patients. Recurrent bleeding occurred in 0% in Banding group vs. 18% in HE 95% CI = 1.15–15.8) and active bleeding at endoscopy (OR = 1.9; 95% CI = 1.04–5.2) were independent predictive factors of early recurrent bleeding. Conclusions  Haemostasis by hemoclips plus epinephrine was an independent predictive factor of rebleeding. This result suggests that band ligation could be the first choice endoscopic treatment for bleeding MWS, but requires further prospective assessment.

Yasuharu Yamaguchi - One of the best experts on this subject based on the ideXlab platform.

  • endoscopic hemoclipping for upper gi bleeding due to Mallory Weiss Syndrome
    Gastrointestinal Endoscopy, 2001
    Co-Authors: Yasuharu Yamaguchi, Taro Yamato, Naoya Katsumi, Katsuro Morozumi, Takashi Abe, Hitoshi Ishida, Shinichi Takahashi
    Abstract:

    Abstract Background: Endoscopic hemoclipping is known to be highly effective as hemostatic treatment for upper gastrointestinal bleeding. However, the efficacy and safety of hemoclipping for Mallory-Weiss Syndrome (MWS) have not been reported. Thus, the aim of the present study was to assess prospectively the usefulness of endoscopic hemoclipping for MWS bleeding. Methods: This study was conducted from January 1994 to August 1999. Hemoclipping was performed when active bleeding (spurting, streaming or oozing), visible vessels or fresh adhesive clots were found on endoscopic examination. Patients who did not have any of these findings were conservatively treated. Follow-up endoscopy was performed within 24 hours, after 5 days and between 1 and 2 months after the procedure. Results: MWS was diagnosed in a total of 58 patients during the study. Hemoclipping was performed in 26 patients and was technically successful in all cases. The average number of hemoclips used was 2.8 ± 1.6 (range 1 to 8). The number of hemoclips required for hemostasis depended on the nature of the bleeding. No complications, recurrent bleeding, or deaths resulted. Follow-up endoscopy showed no evidence of hemoclip-induced tissue injury and no impairment of Mallory-Weiss tears. Conclusion: Endoscopic hemoclipping provided an effective and safe modality for obtaining hemostasis when bleeding is due to MWS. (Gastrointest Endosc 2001;53:427-30.)

  • 7142 endoscopic hemoclipping for upper gastrointestinal bleeding due to Mallory Weiss Syndrome
    Gastrointestinal Endoscopy, 2000
    Co-Authors: Yasuharu Yamaguchi, M Kimura, Taro Yamato, Naoya Katsumi, Katsuro Morozumi, Yasushi Morita, Miki Miura, Toshiyuki Hashimoto, Yoshikazu Yamaguchi, Takashi Abe
    Abstract:

    Aim: Endoscopic treatment with sclerotherapy or thermal methods has been widely used for upper gastrointestinal (UGI ) bleeding due to Mallory-Weiss Syndrome (MWS). However, the potential drawback of thermal methods and the injection of sclerosing agents is that these may cause excessive tissue injury leading to necrosis and perforation. Recently, endoscopic hemoclipping was shown to be highly effective for as a hemostatic treatment for UGI bleeding. Hemoclipping causes less damage to the surrounding area than sclerotherapy or thermal methods. However, the efficacy and safety of hemoclipping for MWS bleeding has not been reported. The aim of the present study was to assess prospectively the usefulness of endoscopic hemoclipping for MWS bleeding. Methods: This prospective study was performed over a 5 year period beginning in January 1994. When patients were diagnosed with MWS by endoscopy , hemoclipping was performed for patients with active bleeding , visible vessel and/or red clots (Group H). The remaining patients with old clots and linear tears in the Esophagogastric junctional (EGJ) mucosa as the only possible origin of bleeding were conservatively treated (Group C). The clinical data and outcome of endoscopic treatment were compared between these two groups. Results: A total of 58 patients underwent emergency endoscopy for UGI bleeding due to MWS from January 1994 to August 1999. During endoscopic examination, active bleeding was found in 17 patients (29%), a visible vessel in one patient (2%) and red clots in 8 patients (14%); Hemoclipping was performed on all 26 patients. Of the remaining 32 patients, 12 patients (21%) had old clots, and 20 (34%) had linear tears without stigmata of recent hemorrhage in the EGJ; these patients did not receive hemoclipping. Significantly more patients in Group H had shock and trasfusional requirements over 800ml than in Group C [the former 4 (17%) vs 0, the latter 4 (17%) vs 0]. The mean hemoglobin level on admission was significantly lower in Group H (10.6±2.9g/dl)than in Group C (12.2±3.0g/dl). Significantly more patients in Group H had critical concomitant diseases than in Group C [14 (54%) vs 8 (25%)]. However, all patients in Group H successfully underwent endoscopic hemostasis with no rebleeding. No patients in Conservative group had rebleeding. No complications related to the endoscopic procedures and no hospital deaths were found in either group. Conclusion : Endoscopic hemoclipping provided an effective and safe modality for securing hemostasis for MWS bleeding.

M Kimura - One of the best experts on this subject based on the ideXlab platform.

  • endoscopic band ligation therapy for upper gastrointestinal bleeding related to Mallory Weiss Syndrome
    Surgical Endoscopy and Other Interventional Techniques, 2006
    Co-Authors: N Higuchi, K Akahoshi, Y Sumida, M Kubokawa, Y Motomura, M Kimura, Masahiro Matsumoto, Kenjiro Nakamura, Hajime Nawata
    Abstract:

    No consensus exists as to the best endoscopic treatment for Mallory-Weiss Syndrome. Endoscopic band ligation is a readily available and easily learned technique. This prospective study evaluated the efficacy and safety of endoscopic band ligation therapy for Mallory–Weiss Syndrome. From August 1998 to June 2005, a clinical trial assessed 37 patients with a diagnosis of Mallory–Weiss Syndrome who had active bleeding, exposed vessels, or both. Their lesions were treated using endoscopic band ligation. Endoscopic band ligation was successful in 36 of 37 cases, with a follow-up period ranging from 1 to 24 months. The remaining patient had severe liver failure and disseminated intravascular coagulation. The patient bled again at 12 h and subsequently died. Except for this case, no recurrent bleeding, perforation, or other complications occurred. The study results suggest that endoscopic band ligation is an effective, safe, and easily learned procedure for treating upper gastrointestinal bleeding related to Mallory–Weiss Syndrome.

  • 7142 endoscopic hemoclipping for upper gastrointestinal bleeding due to Mallory Weiss Syndrome
    Gastrointestinal Endoscopy, 2000
    Co-Authors: Yasuharu Yamaguchi, M Kimura, Taro Yamato, Naoya Katsumi, Katsuro Morozumi, Yasushi Morita, Miki Miura, Toshiyuki Hashimoto, Yoshikazu Yamaguchi, Takashi Abe
    Abstract:

    Aim: Endoscopic treatment with sclerotherapy or thermal methods has been widely used for upper gastrointestinal (UGI ) bleeding due to Mallory-Weiss Syndrome (MWS). However, the potential drawback of thermal methods and the injection of sclerosing agents is that these may cause excessive tissue injury leading to necrosis and perforation. Recently, endoscopic hemoclipping was shown to be highly effective for as a hemostatic treatment for UGI bleeding. Hemoclipping causes less damage to the surrounding area than sclerotherapy or thermal methods. However, the efficacy and safety of hemoclipping for MWS bleeding has not been reported. The aim of the present study was to assess prospectively the usefulness of endoscopic hemoclipping for MWS bleeding. Methods: This prospective study was performed over a 5 year period beginning in January 1994. When patients were diagnosed with MWS by endoscopy , hemoclipping was performed for patients with active bleeding , visible vessel and/or red clots (Group H). The remaining patients with old clots and linear tears in the Esophagogastric junctional (EGJ) mucosa as the only possible origin of bleeding were conservatively treated (Group C). The clinical data and outcome of endoscopic treatment were compared between these two groups. Results: A total of 58 patients underwent emergency endoscopy for UGI bleeding due to MWS from January 1994 to August 1999. During endoscopic examination, active bleeding was found in 17 patients (29%), a visible vessel in one patient (2%) and red clots in 8 patients (14%); Hemoclipping was performed on all 26 patients. Of the remaining 32 patients, 12 patients (21%) had old clots, and 20 (34%) had linear tears without stigmata of recent hemorrhage in the EGJ; these patients did not receive hemoclipping. Significantly more patients in Group H had shock and trasfusional requirements over 800ml than in Group C [the former 4 (17%) vs 0, the latter 4 (17%) vs 0]. The mean hemoglobin level on admission was significantly lower in Group H (10.6±2.9g/dl)than in Group C (12.2±3.0g/dl). Significantly more patients in Group H had critical concomitant diseases than in Group C [14 (54%) vs 8 (25%)]. However, all patients in Group H successfully underwent endoscopic hemostasis with no rebleeding. No patients in Conservative group had rebleeding. No complications related to the endoscopic procedures and no hospital deaths were found in either group. Conclusion : Endoscopic hemoclipping provided an effective and safe modality for securing hemostasis for MWS bleeding.