What are the advantages of an endoscopic epinephrine injection for the treatment of lower gastrointestinal (GI) bleeding (LGIB)?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Endoscopic epinephrine injection is commonly used because of its low cost, easy accessibility, and low risk of complications. In a study of 175 patients who underwent endoscopic epinephrine injection, univariate analysis of 31 patients with rebleeding indicated that factors predictive of a high rebleeding rate included older age (≥60 y), American Society of Anesthesiology (ASA) category III-V; severe anemia greater than 8 g/dL; shock; a minimum epinephrine injection dose of 12 mL; and severe bleeding signs (hematemesis or hematochezia). [73] An additional hemostatic method such as clips or thermoregulation is needed to prevent subsequent bleeding. [5, 73]


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