A team from Barcelona, Spain, investigated the use of endoscopic injection therapy in the management of bleeding Mallory-Weiss tears.
A total of 63 patients who were undergoing emergency endoscopy where enrolled in the study. In all, there was a high index of suspicion that a Mallory-Weiss tear was the source of bleeding.
Each subject was randomly assigned to undergo endoscopic injection therapy (epinephrine and polidocanol) or no endoscopic therapy in 2 university-affiliated hospitals.
Rates of recurrent bleeding, transfusion requirements, complications, mortality, and length of hospital stay were determined for both groups of patients.
|Patients in whom bleeding recurred:|
Endoscopic treatment: 6%
| Gastrointestinal Endoscopy |
Bleeding recurred in 8 patients in the control group versus only 2 in the endoscopic treatment group (26% vs 6%).
The researchers discovered that mean hospital stay was longer for the control group (5.5 vs 3.4 days).
There was a trend toward a higher transfusion requirement after endoscopy in the control group, compared to the patients treated by injection (mean, 0.9 vs 0.2 units).
No complications or adverse events caused by endoscopic injection were noted. However, 2 patients in the control group died of causes unrelated to bleeding.
Dr Josep Llach, of the University of Barcelona, concluded on behalf of the group, "Endoscopic injection therapy is a useful option in the management of patients with Mallory-Weiss syndrome at high risk for recurrent bleeding."