The upper gastrointestinal bleeding, when it develops in a large amount within a short -period of time, should be diagnosed and managed as soon as possible due to its relatively -high mortality. In order to make early diagnosis of upper gastrointestinal bleeding, several different techniques had been tried with no satisfactory result.
Since Palmer introduced in 1967 its concept, however, urgent endoscopy has played an important role in the diagnosis of bleeding lesions. Recent technique made therapeutic endo-
_ scopy available and unnecessary surgery could be avoided.
The author performed endoscopic eectrocoagulation on 304 bleeding lesions in 286 cases requiring urgent endoscopic hemostasis.
The results were as follows:
1) Endoscopic electrocoagulation was performed in 43.8% out of 652 requiring emergency endoscopy
2) Electrocoagulation was applied most frequently 79.7% in cases of peptic ulcer.
toll, 3) The sex incidence of the studied cases showed male predominance with a male: female ratio of 3.7 : 1 and the peak age groups were 5th and 6th decades.
4) The involved site of peptic ulcer lesions were as follows: The gastric body was the most frequently involved (52.7%) along the longitudinal axis, followed by the lesser curvature(46.7%) along the transverse axis in cases of gastric ulcer. In cases of duodenal ulcer, :the duodenal bulb was involved in 90.2% of which anterior wall was the most frequent site of lesion.
5) The bleeding site most commonly seen in Mallory-Weiss syndrome was around the .cardia(44.0/6).
6) The most commonly observed stage according to the endoscopic staging of peptic ulcer was the active stage(88.1%).
7) The types of bleeding seen in descending order in the 304 lesions were´ the form of
blood clots(34.80), due to exposed vessels(27.0%), oozing(24.7%), projecting(7. 2%6), and spring (6.30), and showed different patterns of bleeding according to their specific causative diseases.
8) The selection of the type of endoscope used for the electrocoagulation depended on the involved site of lesion.
9) Endoscopic electrocoagulation resulted in effective hemostasis in 96.40 out of all cases.
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