Current Status of Endoscopic Hemostasis for Severely Bleeding Ulcers

Abstract

Severe peptic ulcer bleeding is associated with high mortality. Patients presenting at endoscopy with an ulcer with an actively bleeding vessel have ±80% chance of persistent or recurrent bleeding. Patients presenting with a non-bleeding visible vessel in an ulcer crater have a ±50% chance of rebleeding. Endoscopic therapy of the bleeding or non-bleeding visible vessels aims at decreasing the duration of bleeding, the recurrence rate of bleeding, the transfusion needs, the emergency surgery rate, and the mortality. Several endoscopic modalities for hemostasis have been developed. The most promising are Yag laser photocoagulation, bicap therapy, heater probe coagulation, and injection therapy. These modalities and the available clinical data on endoscopic ulcer hemostasis are thoroughly discussed.

Key Words:

• Endoscopy
• hemostasis
• ulcer
• vessel