Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Gastroenterology
Volume 3, Issue 2, Pages 72-76
http://dx.doi.org/10.1155/1989/582342
Review

Endoscopic Methods for the Treatment of Nonvariceal Upper Gastrointestinal Hemorrhage

Z.W. Li, F. Urrutia, R. Wensel, and A.B.R. Thomson

Nutrition and Metabolism Research Group, Division of Gastroenterology, Department of Medicine, University of Alberta, Edmnton, Alberta, Canada

Received 1 February 1988; Accepted 15 February 1988

Copyright © 1989 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In the l970s, diagnostic fibreoptic endoscopy became part of the standard practice for evaluation of gastrointestinal disease. In the 1980s, therapeutic fibreoptic endoscopy is emerging as standard therapy for many gastrointestinal diseases. As the already sophisticated technology continues to blossom, it promises to become even more a part of the management of an increasing number of gastroenterological problems. Endoscopy can provide both a specific diagnosis as well as an identification of the high risk subgroup of patients with either active bleeding, or a non bleeding visible vessel that might benefit from endoscopic treatment. At endoscopy, patients with active ulcer bleeding have either arterial spurting, oozing or oozing beneath an overlying clot. These have poor outcomes: for example, when a non bleeding visible vessel is identified, the chances for rebleeding are approximately 50% during the period of that hospitalization . With an overlying clot without oozing, where dark spots are noted, there is less than a 10% chance of rebleeding. There are certain limitations for endoscopic hemostatic therapy and there are a few bleeding ulcers with an artery too large to expect endoscopic success. The kind of treatment chosen will be dictated by the availability of the therapeutic modalities and the skill of the surgeon.