Application of endoscopic hemoclips for nonvariceal bleeding in the upper gastrointestinal tract

AIM:To investigate acute nonvariceal bleeding in the upper gastrointestinal(GI)tract and evaluate the effects of endoscopic hemoclipping. METHODS:Sixty-eight cases of acute nonvariceal bleeding in the upper GI tract were given endoscopic treatment with hemoclip application.Clinical data, endoscopic findings,and the effects of the therapy were evaluated. RESULTS:The 68 cases(male:female=42:26,age from 9 to 70 years,average 54.4)presented with hematemesis in 26 cases(38.2%),melena in nine cases(13.3%),and both in 33 cases(48.5%).The causes of the bleeding included gastric ulcer(29 cases),duodenal ulcer(11 cases),Dieulafoy’s lesion (11 cases),Mallory-Weiss syndrome(six cases),post- operative(three cases),post-polypectomy bleeding (five cases),and post-sphincterotomy bleeding(three cases);42 cases had active bleeding.The mean number of hemoclips applied was four.Permanent hemostasis was obtained by hemoclip application in 59 cases;6 cases required emergent surgery(three cases had peptic ulcers,one had Dieulafoy’s lesion,and two were caused by sphincterotomy);three patients died(two had Dieulafoy’s lesion and one was caused by sphincterotomy);and one had recurrent bleeding with Dieulafoy’s lesion 10 mo later,but in a different location. CONCLUSION:Endoscopic hemoclip application wasan effective and safe method for acute nonvariceal bleeding in the upper GI tract with satisfactory outcomes.