O형 고무 밴드 결찰법을 이용한 Mallory-Weiss 증후군의 치료 = Esophagus, Stomach & Intestine;Management of Mallory-Weiss Syndrome by 0-ring Band Ligation

다국어 초록 (Multilingual Abstract)

Background/Aims: Mallory-Weiss syndrome refers to a laceration or lacerations in the region of the gastroesophageal junction due to vomiting, retching, or coughing induced by several causes, and preceding hematemesis. In the last several years, endoscopic therapies have dramatically changed the need for emergency surgery in patients with upper gastrointestinal bleeding. There is only little information however, regarding the indication criteria and the efficacy of endoscopic therapies in severe upper gastrointestinal bleeding, due to Mallory-Weiss syndrome. This study was designed to assess the usefulness and the indications of endoscopic O-ring band ligation. Methods: Thirty patients with Mallory- Weiss syndrome who were experiencing a related hemorrhage were studied. Among these, 5 patients with active bleeding or a visible vessel revealed during an endoscopic examination were treated with O-ring band ligation. Patients with blood clots or linear tears received only conservative treatment. Result : 1) It was determined that Mallory-Weiss syndrome was the cause of bleeding n 6.1% of patients with upper gastrointestinal bleeding. 2) active bleeding or a visible vessel seen in an endoscopic examination was found in 5 patients (16.7%); definitive heomostasis was obtained in all cases with O-ring band ligation. 3) The remaining 25 patients were successfully teated with conservative therapy. 4) Patients undergoing O-ring band ligation displayed a significantly lower initial diastolic blood pressure and hemoglobin levels, and also showed significantly more numbers of melena and needed more transfusions than patients with conservative therapy. Conclusions: Severe bleeding due to Mallory-Weiss syndrome can be successfully treated by O-ring band ligation. Moreover, active bleeding or visible vessel detected in n endoscopic examination can be considered an indication of O-ring band ligation in upper gastrointestinal bleeding due to Mallory-Weiss syndrome.