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Which types of non‐bleeding visible vessels in gastric peptic ulcers should be treated by endoscopic hemostasis?
Author(s) -
AMANO Y,
MORIYAMA N,
SUETSUGU H,
ISHIMURA N,
IMAOKA T,
KOMAZAWA Y,
FUJISHIRO H,
ISHIHARA S,
ADACHI K,
KINOSHITA Y
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03189.x
Subject(s) - medicine , bleed , hemostasis , endoscopy , peptic , stomach , surgery , gastrointestinal bleeding , upper gastrointestinal bleeding , gastroenterology , peptic ulcer
Background and Aims: Because non‐bleeding visible vessels (NBVV) of gastric peptic ulcers have the potential to re‐bleed, endoscopic hemostatic treatment may be necessary during the first emergency endoscopy. However, not all NBVV re‐bleed, and endoscopic hemostasis sometimes causes fatal side‐effects. Therefore, we have evaluated the risk of re‐bleeding from various NBVV in gastric peptic ulcers to determine which types should be treated by endoscopy to prevent re‐bleeding. Methods: A total of 227 NBVV in 202 patients with gastric peptic ulcers that were endoscopically followed without endoscopic hemostatic procedures were classified by the following factors: vessel color, form, location of the NBVV in the ulcer crater, and location of the ulcer in the stomach. The re‐bleeding rate was then analyzed for each type of NBVV. Results: Significantly high rates of re‐bleeding were observed in cases with white, protruded and peripheral NBVV. In particular, white NBVV located in the peripheral zone of the ulcer crater were frequent re‐bleeding sources. The location of the ulcer in the stomach was not a statistically significant factor in determining re‐bleeding rates. Conclusion: We found that white, protruded and peripherally located NBVV in gastric ulcers have a higher chance of re‐bleeding if preventive endoscopic hemostatic procedures are not performed.