Abstract:
BACKGROUND:Procedure-induced bleeding is a major complication after endoscopic intervention. AIMS:The aim of this study was to investigate the risk of endoscopy-related bleeding in patients with chronic hematologic thrombocytopenia. METHODS:We investigated endoscopy-related bleeding in 175 procedures performed on 108 patients with immune thrombocytopenic purpura or aplastic anemia. The outcomes were compared with those of 350 procedures on age-, sex-, and procedure-matched control subjects. Endoscopic interventions included low-risk procedures such as endoscopic biopsy and high-risk procedures including polypectomy, endoscopic resection, and endoscopic retrograde cholangiopancreatogram with sphincterotomy. RESULTS:Bleeding occurred in 17 (9.7%) procedures among the patients with thrombocytopenia. This rate was significantly higher than that in procedures on controls (3.1%, P = 0.003). About 60% of all bleeding events were observed within 24 h after the endoscopic procedure. Bleeding after endoscopic biopsy developed more frequently in the patient group than in the control group (7.1 vs. 0.7%; P < 0.001). Bleeding occurred after 20% of all high-risk procedures. The incidence of bleeding was significantly elevated in patients with a platelet count less than 50 × 103/μl. Multivariate analysis revealed that high-risk procedures and low platelet count (less than 50 × 103/μl) were significantly related to procedure-related bleeding. All bleeding events stopped spontaneously or were controlled with endoscopic hemostasis. CONCLUSIONS:Endoscopic procedure-related bleeding develops frequently in patients with chronic hematologic thrombocytopenia. Post-procedural bleeding should be observed carefully in these patients, especially when the platelet count is less than 50 × 103/μl or high-risk endoscopic procedures are planned.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Oh HJ,Park JM,Yoon SB,Lee HH,Lim CH,Kim JS,Cho YK,Lee BI,Cho YS,Choi MGdoi
10.1007/s10620-016-4427-4subject
Has Abstractpub_date
2017-03-01 00:00:00pages
746-754issue
3eissn
0163-2116issn
1573-2568pii
10.1007/s10620-016-4427-4journal_volume
62pub_type
杂志文章abstract::The gastric acid response to a 200-ml cup of tea was measured by in situ titration in 36 patients with duodenal ulcer (DU) and 56 without duodenal ulcer (controls). Tea resulted in an acid secretory response which was almost equal to that after a maximal dose (0.04 mg/kg) of histamine. The effect of tea was mainly due...
journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
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