Chemical Mechanical Hemostasis in Bleeding from Varicose Veins of the Esophagus

INTRODUCTION: Currently, the list of methods of hemostasis applicable to patients with portal hypertension at the height of bleeding from the esophageal veins, is extremely limited. There is a need for new methods that can improve the results of treatment by replacing the existing approaches or supplementing them.

AIM: To develop and test a new method for stopping bleeding from esophageal veins, applicable in the same clinical situations as compression hemostasis, but with better characteristics.

MATERIALS AND METHODS: The material for study was the results of treatment of 30 patients hospitalized in the Ryazan Emergency Care Hospital in 2022–2023 for completed bleeding from the esophageal veins, with the underlying hepatic cirrhosis and portal hypertension. In case of recurrent bleeding, patients of the study group underwent a session of chemical mechanical hemostasis (CMH) combining compression of esophageal veins and the effect of the liquid local hemostatic drug on them. All patients included in the study were surveyed to determine their subjective attitude to the treatment.

RESULTS: A single CMH session caused persistent cessation of bleeding 1.4 times less often than a classic obturator probe, but at the same time reduced the duration of the procedure from 10 hours to 5 minutes. In addition, the use of CMH was associated with 1.3 times reduction of the mortality and a lower level of distressing sensations for the patient during the procedure.

CONCLUSION: In the conducted study, CMH demonstrated the ability to save 46.7% of patients the necessity of installing a standard obturator probe for a long time and thus to radically reduce sensations experienced by the patient during treatment.