Forty-four patients who had bled from peptic ulcers and whose ulcers showed stigmata
of haemorrhage (bleeding, visible vessel or adherent clot) entered a trial of treatment
with a 3.2 mm bipolar diathermy probe. Two patients had spurting haemorrhage when
endoscoped and both were treated with the probe, control being obtained in one. The
remaining patients were randomised to treatment or control groups. One patient who
was treated was withdrawn because the ulcer proved to be malignant. Six of 20 treated
patients rebled compared with 8 of 21 controls (relative risk 0.79; 90 % C1 0.26-1.97).
The operation rate, transfusion requirement and hospital stay were similar in the
two groups. One perforation occurred in the treatment group. Per-endoscopic bipolar
diathermy treatment confers little benefit in bleeding peptic ulcer disease.
Bipolar diathermy coagulation - Peptic ulcers - Stigmata of haemorrhage - Visible
vessel
