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Endoscopic management of peptic ulcer bleeding.

Kim JS, Park SM, Kim BW - Clin Endosc (2015)

Bottom Line: Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding.This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications.Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.

ABSTRACT
Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.

No MeSH data available.


Related in: MedlinePlus

Endoscopic findings. (A) A non-bleeding visible vessel on ulcer base was observed at upper body of stomach. (B) Argon plasma coagulation was performed in the visible vessel.
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Figure 2: Endoscopic findings. (A) A non-bleeding visible vessel on ulcer base was observed at upper body of stomach. (B) Argon plasma coagulation was performed in the visible vessel.

Mentions: Thermal contact therapy can be classified into contact or noncontact methods. Contact methods consists of heater probe or bipolar electrocoagulation and noncontact methods consist of argon plasma coagulation (Fig. 2).23 Thermal methods are significantly effective in achieving initial hemostasis, reducing further bleeding, surgery, and mortality.21 Currently, no significant difference has been found between the different thermal modalities. Two studies reported that epinephrine injection followed by thermal therapy was more effective than thermal therapy alone.24,25 Thermal contact therapy should be performed with the tip of the probe as close as possible to the bleeding ulcer. Endoscopic caps may be used to improve visualization and access for therapy.26 When available, use of soft caps is preferred to minimize contact bleeding.


Endoscopic management of peptic ulcer bleeding.

Kim JS, Park SM, Kim BW - Clin Endosc (2015)

Endoscopic findings. (A) A non-bleeding visible vessel on ulcer base was observed at upper body of stomach. (B) Argon plasma coagulation was performed in the visible vessel.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4381136&req=5

Figure 2: Endoscopic findings. (A) A non-bleeding visible vessel on ulcer base was observed at upper body of stomach. (B) Argon plasma coagulation was performed in the visible vessel.
Mentions: Thermal contact therapy can be classified into contact or noncontact methods. Contact methods consists of heater probe or bipolar electrocoagulation and noncontact methods consist of argon plasma coagulation (Fig. 2).23 Thermal methods are significantly effective in achieving initial hemostasis, reducing further bleeding, surgery, and mortality.21 Currently, no significant difference has been found between the different thermal modalities. Two studies reported that epinephrine injection followed by thermal therapy was more effective than thermal therapy alone.24,25 Thermal contact therapy should be performed with the tip of the probe as close as possible to the bleeding ulcer. Endoscopic caps may be used to improve visualization and access for therapy.26 When available, use of soft caps is preferred to minimize contact bleeding.

Bottom Line: Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding.This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications.Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.

ABSTRACT
Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.

No MeSH data available.


Related in: MedlinePlus