Massive bleeding of esophageal ulcer: treatment by endoscopic ligation

Acute upper GI hemorrhage remains a common cause of hospitalization and still has a small but definite mortality rate. 1 Clason AE Macleod DAD Elton RA. Clinical factors in the prediction of further haemorrhage or mortality in acute upper gastrointestinal haemorrhage. Br J Surg. 1986; 73: 985-987 Crossref PubMed Scopus (93) Google Scholar , 2 Sugawa C Steffes CP Nakamura R Sferra JJ Sferra CS Sugimura Y et al. Upper GI bleeding in an urban hospital: etiology,recurrence, and prognosis. Ann Surg. 1990; 212: 521-527 Crossref PubMed Scopus (77) Google Scholar , 3 Segal WN Cello JP. Hemorrhage in the upper gastrointestinal tract in the older patient. Am J Gastroenterol. 1997; 92: 42-46 PubMed Google Scholar The development of endoscopic treatments for upper GI bleeding has decreased transfusion requirements, the need for operation, and mortality. 4 Williams RA Vartany A Davis IP Wilson SE. Impact of endoscopic therapy on outcome of operation for bleeding peptic ulcers. Am J Surg. 1993; 166: 712-715 Abstract Full Text PDF PubMed Scopus (21) Google Scholar , 5 Sugawa C. Endoscopic diagnosis and treatment of upper gastrointestinal bleeding. Surg Clin North Am. 1989; 69: 1167-1183 PubMed Google Scholar The most probable causes of bleeding are acute gastric mucosal lesions, gastroduodenal ulcers, and esophageal varices. It is rare that esophageal ulcers cause severe or persistent bleeding that requires endoscopic hemostasis. 6 Fleischer D. Etiology and prevalence of severe persistent upper gastrointestinal bleeding. Gastroenterology. 1983; 84: 538-543 PubMed Google Scholar