The management of upper gastrointestinal bleeding in hemophilia patients by sclerotherapy [Hemofili hastalarinda ust gastrointestinal sistem kanamasinin endoskopik skleroterapi ile tedavisi]

Upper gastrointestinal bleeding is a common finding in hemophilia patient's and has an incidence of 20%. Endoscopic sclerotherapy is a widely and successfully used treatment for upper gastrointestinal bleeding in Turkey as in other countries. Studies regarding the effectiveness of sclerotherapy in patients who have bleeding diathesis and upper gastrointestinal bleeding, such as in hemophilia, are limited in number. In our study, seven hemophilia patients with an age rance of 32 to 55 were studied. All patients had upper gastrointestinal bleeding and the effectiveness of sclerotherapy was retrospectively analyzed from 1991 to 1995. All patients were endoscopically examined with in the first 24 hours of admission was duodenal ulcer was diagnosed in four cases, hemorrhagic gastritis in two, and gastric ulcer in one. In four of the patients, active bleeding was observed and injection sclerotherapy (adrenalin 1/10.000 and polydocanol % 1) was performed successfully, with hemostasis occuring during endoscopy. These patients had a history of former gastrointestinal bleeding. In addition to sclerotherapy, factor VIII and fresh blood were administered. In two patients there was a recurrence of bleeding after 6 mounts but endoscopicaly active bleeding could not be seen. Conclusion: Endoscopic injection sclerotherapy is a safe and effective method in the treatment of upper gastrointestinal bleeding in hemophilia.