Which types of non-bleeding visible vessels in gastric peptic ulcers should be treated by endoscopic hemostasis?

Authors: AMANO, Y; MORIYAMA, N¹; SUETSUGU, H¹; ISHIMURA, N¹; IMAOKA, T¹; KOMAZAWA, Y²; FUJISHIRO, H²; ISHIHARA, S²; ADACHI, K²; KINOSHITA, Y²

Source: Journal of Gastroenterology and Hepatology, Volume 19, Number 1, January 2004 , pp. 13-17(5)

Publisher: Wiley-Blackwell

Abstract:

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.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1440-1746.2004.03189.x

Affiliations: 1: Department of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan 2: Medicine II, Shimane Medical University,

Publication date: 2004-01-01

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• In this Subject: Gastroenterology
• By this author: AMANO, Y ;  MORIYAMA, N ;  SUETSUGU, H ;  ISHIMURA, N ;  IMAOKA, T ;  KOMAZAWA, Y ;  FUJISHIRO, H ;  ISHIHARA, S ;  ADACHI, K ;  KINOSHITA, Y

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