SELECTIVE VASOCONSTRICTOR INFUSION IN THE MANAGEMENT OF ARTERIO-CAPILLARY GASTROINTESTINAL HEMORRHAGE

Thirty-eight patients with active, arteriocapillary gastrointestinal bleeding were treated by the selective arterial infusion of epinephrine or vasopressin.Vasoconstrictive therapy had a success rate of 80 per cent in small vessel bleeding. Complete control of bleeding was achieved in 20; temporary control in 3; and no control in 2 of 25 patients with gastritis, superficial stress ulcers, the Mallory-Weiss syndrome or colic lesions.Selective vasoconstriction had limited value in the management of large artery bleeding from peptic ulcers, affording complete control in 2, temporary control in 2, and no control in 9 (70 per cent) of 13 patients.Individual factors of importance in the conduct of treatment include: the patient's general condition, the adequacy of supportive therapy, the angiographic demonstration of the bleeding, the character and location of the bleeding lesion, the obtainable degree of infusion selectivity, choice of the vasoconstrictor, vascular response achieved, and the patient's clotting...