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Digestive Diseases and Sciences

, Volume 44, Issue 4, pp 778–781 | Cite as

Thrombin Is Effective in Arresting Bleeding from Gastric Variceal Hemorrhage

  • Robert T. Przemioslo
  • A. Mcnair
  • R. Williams
Article

Abstract

Gastric variceal hemorrhage is associated witha high morbidity and mortality. We report the efficacyand safety of bovine thrombin in the treatment ofbleeding gastric varices. At endoscopy 52 patients with hematemesis were diagnosed with bleedinggastric varices. Patients were treated by intravaricealinjection with bovine thrombin and underwent furtherendoscopy at 72 hr and then at two-week intervals. Initial hemostasis was achieved in 49/52patients (94%). Bleeding-related mortality at 72 hrafter the index bleed was 3/52 (6%). The mean amount ofthrombin used to achieve initial hemostasis was 1070 IU (range 400-2000 IU) and no adverse drugeffects were observed. The median number of treatmentsessions required to achieve gastric variceal ablationwas 2 (range 1-3). At six weeks, 9 of 49 surviving patients (18%) rebled and one further patientdied. The six-week mortality in patients treated withthrombin was 4/52 (8%). In conclusion, safe andeffective hemostasis of bleeding gastric varices can be achieved by intravariceal injection withthrombin.

GASTRIC VARICEAL HEMORRHAGE BOVINE THROMBIN 

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Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Robert T. Przemioslo
  • A. Mcnair
  • R. Williams

There are no affiliations available

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