Guidelines For Clinical Practice
Copyright ©2010 Baishideng.
World J Gastrointest Endosc. Feb 16, 2010; 2(2): 54-60
Published online Feb 16, 2010. doi: 10.4253/wjge.v2.i2.54
Table 1 Causative diseases for upper GI-hemorrhage
EsophagusEsophageal varices
Esophagitis
Mallory-weiss syndrome
Esophageal cancer
Others (aortointestinal fistula, foreign body, etc.)
StomachUlcer (peptic ulcer, NSAID-associated ulcer, dieulafoy’s lesion, etc.)
AGML
Gastric varices
Gastric cancer
Other tumor (GIST, malignant lymphoma, etc.)
Vascular ectasia, GAVE, PHG
Hyperplastic polyp
Others (foreign body, etc.)
DuodenumUlcer (peptic ulcer, NSAID-associated ulcer, dieulafoy’s lesion, etc.)
Duodenitis
Duodenal varices
Diverticulum
Tumor (cancer, malignant lymphoma, GIST, etc.)
Invasion of malignant tumor (pancreas, bile duct, etc.)
Others (hemobilia, aortointestinal fistula, etc.)
Table 2 Method of endoscopic hemostasis
Mechanical methodHemoclip
Balloon tamponade
Ligation (EVL, detachable snare)
Injection methodEthanol
Epinephrine
Monoethanolamine oleate
Polidocanol
N-butyl-2-cyanoacrylate
Thermo-coagulationAPC
Heater prove
Hemostatic forceps
Microwaves
Laser (Nd-YAG, diode, etc.)
Hemostyptic spraysThrombin
Sodium alginate
Fibrin glue
Table 3 Modified Forrest classification of hemorrhagic gastric ulcer
Active bleedingType Ia: spurting bleeding
Type Ib: oozing bleeding
Recent bleedingType IIa: non-bleeding visible vessel
Type IIb: adherent blood clot
Type IIc: black base
No bleedingType III: no stigma