One hundred and seven consecutive patients presenting with significant peptic ulcer haemorrhage were randomised to endoscopic injection with 3-10 ml of 1:100,000 adrenaline (55 patients, group 1) or to a combination of adrenaline and 5% ethanolamine (52 patients, group 2). All had major stigmata of haemorrhage and endoscopic injection was undertaken by a single endoscopist. The groups were well...

Variceal bleeding is the most important complication of portal hypertension. Mortality due to the first variceal bleeding is very high (50%) and of those surviving a variceal bleeding episode, up to 80% may rebleed. Proper management of the acute variceal bleeding episode, the prevention of rebleeding and primary prophylaxis for variceal haemorrhage are therefore mandatory in order to improve t...

Variceal bleeding is a life-threatening complication of cirrhosis. Potential risk factors include clinical, endoscopic, and haemodynamic factors, but why bleeding occurs unpredictably in individual patients is not known. We postulate that bacterial infections in patients with variceal haemorrhage may be the critical factor that triggers bleeding. In patients with large varices and a high wall t...

Acute variceal bleeding accounts for just over 10% of all causes of upper gastrointestinal bleeding presenting to hospital, with two-thirds of these patients having a history of previous variceal bleeding [1]. It is a medical emergency associated with 10-20% mortality within 6 weeks. However, recent improvements in outcome following variceal haemorrhage have been reported and several important ...

Acute bleeding from the colon and rectum is less frequent and less dramatic than haemorrhage from the upper gastrointestinal tract. In most cases, bleeding from the colon and rectum is self-limiting and requires no specific therapy. Diverticula and angiectasias are the most frequent sources of bleeding. Malignancy, colitis (inflammatory bowel disease, non-steroidal anti-inflammatory drugs, and ...

Haemophilia A is a bleeding disorder that has a spectrum of manifestations ranging from persistent bleeding after minor trauma to spontaneous haemorrhage. As an X-linked disease, it has a rare occurrence in females. We report a case of a pregnant patient with severe haemophilia A, who received epidural analgesia during labour. The prepartum, intrapartum and postpartum care of a patient with suc...

A debilitated patient with liver cirrhosis and poor haemostasis had a severe lower gastrointestinal haemorrhage. A superior mesenteric arteriogram revealed an early persistent and promiment draining vein in the ileocolic artery. Two fragments of Spongostan and silk were used to embolise the bleeding artery and the haemorhage ceased immediately. No infarction of the embolised area was observed a...

EDITORIAL COMMENT The causal relationship between aspirin and gastroduodenal haemorrhage is critically examined. Occult bleeding showed that as a group patients who had had a severe gastrointestinal bleed were not strikingly different from a group of people with normal digestive tracts. It seems likely that overt bleeding may be due to an idosyncratic response developing only in particular circ...

Epithelioid angiosarcoma is a rare, highly malignant tumour with a poor prognosis. We present the case of a 75 year old man who underwent an incision biopsy to diagnose the soft tissue tumour and suffered from surgically uncontrollable haemorrhage. The case report demonstrates the value of interventional radiology for acute bleeding and radiotherapy for more chronic tumour bleeding.