消化管出血に対する非手術的治療　　消化管出血原因疾患の変遷と非手術的治療の意義

DOI 被引用文献6件 参考文献35件

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  • Alteration in the Causes of Gastrointestinal Bleeding and Significance of non-operative Hemostatic Therapies

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The causes of gastrointestinal bleeding have been changed remarkably during the past four decades. In the 1960s, infectious disease accounted for most of the bleeding in the lower alimentary tract now, however, colorectal carcinoma has become the primary cause of bleeding in this region. On the other hand, gastric ulcers remain the most common cause of upper gastrointestinal bleeding. Recently, endoscopic clipping has been confirmed as the best choice for hemostasis in patients with of gastric ulcer bleeding, especially when the bleeding occurs from naked vessels. Between 2003 and 2004, emergency endoscopic treatment for hemostasis was performed in 517 patients at Fujita Health University Hospital. Successful hemostasis was achieved in 514 (99.4%) patients the remaining three cases (0.6%) required surgery. None of the patients died from gastric ulcer bleeding. Although most cases of gastrointestinal bleeding could be successfully treated using an endoscopic approach, care is needed as a few cases remain difficult to treat using endoscopic hemostasis alone.

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