Clinical Endoscopy

Original Article

Endoscopy Timing in Patients with Acute Upper Gastrointestinal Bleeding: Gonçalo Alexandrino, Tiago Dias Domingues, Rita Carvalho, Mariana Nuno Costa, Luís Carvalho Lourenço, Jorge Reis; Clin Endosc 2019;52(1):47-52. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.093

Background
/Aims: The role of very early (≤12 hours) endoscopy in nonvariceal upper gastrointestinal bleeding is controversial. We aimed to compare results of very early and early (12–24 hours) endoscopy in patients with upper gastrointestinal bleeding demonstrating low-risk versus high-risk features and nonvariceal versus variceal bleeding.
Methods
This retrospective study included patients with nonvariceal and variceal upper gastrointestinal bleeding. The primary outcome was a composite of inpatient death, rebleeding, or need for surgery or intensive care unit admission. Endoscopy timing was defined as very early and early. We performed the analysis in two subgroups: (1) high-risk vs. low-risk patients and (2) variceal vs. nonvariceal bleeding.
Results
A total of 102 patients were included, of whom 59.8% underwent urgent endoscopy. Patients who underwent very early endoscopy received endoscopic therapy more frequently (p=0.001), but there was no improvement in other clinical outcomes. Furthermore, patients at low risk and with nonvariceal bleeding who underwent very early endoscopy had a higher risk of the composite outcome.
Conclusions
Very early endoscopy does not seem to be associated with improved clinical outcomes and may lead to poorer outcomes in specific populations with upper gastrointestinal bleeding. The actual benefit of very early endoscopy remains controversial and should be further clarified.

Citations

Citations to this article as recorded by

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BMC Gastroenterology.2025;[Epub] CrossRef
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Urgent endoscopy versus early endoscopy: Does urgent endoscopy play a role in acute non-variceal upper gastrointestinal bleeding?
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Journal of Gastroenterology and Hepatology.2021; 36(10): 2819. CrossRef
Biopsy in emergency gastroscopy does not increase the risk of rebleeding in patients with Forrest I acute nonvariceal upper gastrointestinal bleeding combined with suspected malignant gastric ulcer: a multicenter retrospective cohort study
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BMC Gastroenterology.2021;[Epub] CrossRef
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Annals of Medicine and Surgery.2021; 71: 102958. CrossRef
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Upper gastrointestinal bleeding: Is only an injection of epinephrine sufficient? Success rates by Forrest classification
Ahmet Surek, Eyup Gemici, Abdussamet Bozkurt, Mehmet Karabulut
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24 Crossref

Review

Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding: Jae-Young Jang; Clin Endosc 2016;49(5):417-420. Published online September 30, 2016; DOI: https://doi.org/10.5946/ce.2016.135

Abstract PDF PubReader ePub

Peptic ulcer bleeding is an internal medical emergency. Endoscopic hemostasis has been shown to improve the survival rate of patients with peptic ulcer bleeding. Although the established hemostatic modalities, including injection, thermal therapy, and mechanical therapy, are effective in controlling peptic ulcer bleeding, hemostasis can be difficult to achieve in some cases. As a result, recent, new endoscopic hemostatic modalities, including over-the-scope clips, topical hemostatic sprays, and endoscopic ultrasonography-guided angiotherapy, have been developed.

Citations

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Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
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Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef
Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
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Mohammad Javad Zahedi, Sara Shafieipour, Mohammad Mahdi Hayatbakhsh Abbasi, Mohsen Nakhaie, Mohammad Rezaei Zadeh Rukerd, Mohammad Mehdi Lashkarizadeh, Farbood Noorbini, Mohammad Hasan Baghaei, Abbas Pourjafari, Ebrahim Aminian, Fatemeh Karami Robati, Aza
Middle East Journal of Digestive Diseases.2022; 14(4): 404. CrossRef
Urban-Rural Disparities and Temporal Trends in Peptic Ulcer Disease Epidemiology, Treatment, and Outcomes in the United States
Howard Guo, Angela Y. Lam, Abdel Aziz Shaheen, Nauzer Forbes, Gilaad G. Kaplan, Christopher N. Andrews, Michael Laffin, Siddharth Singh, Vipul Jairath, Anouar Teriaky, Jeffrey K. Lee, Christopher Ma
American Journal of Gastroenterology.2021; 116(2): 296. CrossRef
Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum
Volodymyr Mamchych, Sergiy Vereshchagin, Volodymyr Maksymchuk, Dmytro Maksymchuk
EUREKA: Health Sciences.2021; (2): 37. CrossRef
Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy
Hiroyuki Abe, Kenya Kamimura, Yoshihisa Arao, Junji Kohisa, Shuji Terai
Medicines.2021; 8(9): 53. CrossRef
Acute upper gastrointestinal bleeding: A review
Elroy Patrick Weledji
Surgery in Practice and Science.2020; 1: 100004. CrossRef
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International Journal of Surgery: Global Health.2020; 3(3): e18. CrossRef
Upper gastrointestinal bleeding: Is only an injection of epinephrine sufficient? Success rates by Forrest classification
Ahmet Surek, Eyup Gemici, Abdussamet Bozkurt, Mehmet Karabulut
Sanamed.2020; 15(3): 309. CrossRef
Endoscopic closure of iatrogenic colon perforation using dual-channel endoscope with an endoloop and clips: methods and feasibility data (with videos)
Ja Young Ryu, Byung Kwan Park, Won-Seok Kim, Kisung Kim, Jae Young Lee, Young Kim, Jae Yong Park, Beom Jin Kim, Jeong Wook Kim, Chang Hwan Choi
Surgical Endoscopy.2019; 33(4): 1342. CrossRef
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338 Download
9 Web of Science
12 Crossref

Original Article

Usefulness of the Forrest Classification to Predict Artificial Ulcer Rebleeding during Second-Look Endoscopy after Endoscopic Submucosal Dissection: Duk Su Kim, Yunho Jung, Ho Sung Rhee, Su Jin Lee, Yeong Geol Jo, Jong Hwa Kim, Jae Man Park, Il-Kwun Chung, Young Sin Cho, Tae Hoon Lee, Sang-Heum Park, Sun-Joo Kim; Clin Endosc 2016;49(3):273-281. Published online March 4, 2016; DOI: https://doi.org/10.5946/ce.2015.086

Abstract PDF PubReader ePub

Background
/Aims: Delayed post-endoscopic submucosal dissection (ESD) bleeding (DPEB) is difficult to predict and there is controversy regarding the usefulness of prophylactic hemostasis during second-look endoscopy. This study evaluated the risk factors related to DPEB, the relationship between clinical outcomes and the Forrest classification, and the results of prophylactic hemostasis during second-look endoscopy.
Methods
Second-look endoscopy was performed on the day after ESD to check for recent hemorrhage or potential bleeding and the presence of artificial ulcers in all patients.
Results
DPEB occurred in 42 of 581 patients (7.2%). Multivariate analysis determined that a specimen size ≥40 mm (odds ratio [OR], 3.03; p=0.003), and a high-risk Forrest classification (Forrest Ib+IIa+IIb; OR, 6.88; p<0.001) were risk factors for DPEB. DPEB was significantly more likely in patients classified with Forrest Ib (OR, 24.35; p<0.001), IIa (OR, 12.91; p<0.001), or IIb (OR, 8.31; p<0.001) ulcers compared with Forrest III ulcers. There was no statistically significant difference between the prophylactic hemostasis and non-hemostasis groups (Forrest Ib, p=0.938; IIa, p=0.438; IIb, p=0.397; IIc, p=0.773) during second-look endoscopy.
Conclusions
The Forrest classification of artificial gastric ulcers during second-look endoscopy seems to be a useful tool for predicting delayed bleeding. However, routine prophylactic hemostasis during second-look endoscopy seemed to not be useful for preventing DPEB.

Citations

Citations to this article as recorded by

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Case Report

Endoscopic Management of Rectal Dieulafoy's Lesion: A Case Series and Optimal Treatment: Jung Gil Park, Jung Chul Park, Yong Hwan Kwon, Sun Young Ahn, Seong Woo Jeon; Clin Endosc 2014;47(4):362-366. Published online July 28, 2014; DOI: https://doi.org/10.5946/ce.2014.47.4.362

Abstract PDF Supplementary Material PubReader ePub

Rectal Dieulafoy's lesion (DL) is rare cause of lower gastrointestinal bleeding. Because of its rarity, there is no consensus on the optimal endoscopic hemostasis technique for rectal DL. We analyzed six patients who underwent endoscopic management for rectal DL after presenting with hematochezia at a single institute over 10 years. Of the six patients, three underwent endoscopic band ligation (EBL) and three underwent endoscopic hemoclip placement (EHP). Only one patient was treated with thermocoagulation. There were no immediate complications in any of the patients. None of the patients required a procedure or surgery for the treatment of rebleeding. Mean procedure times of EBL and EHP were 5.25 minutes and 7 minutes, respectively. Both EHP and EBL are shown to be effective in the treatment of bleeding rectal DL. We suggest that EBL may have potential as the preferred therapy owing to its superiority in technical and economic aspects, especially in elderly and high-risk patients.

Citations

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Over-the-scope clip as a rescue treatment for massive bleeding due to Dieulafoy lesion at the colorectal anastomosis: A case report
Ping Han, Demin Li, Qiaozhen Guo, Yu Lei, Jingmei Liu, Dean Tian, Wei Yan
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Ping Han, Yu Lei, Wei Hou, Nianjun Chen, Jingmei Liu, Dean Tian, Qiaozhen Guo, Wei Yan
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Endoscopic management of massive rectal bleeding from a Dieulafoy's lesion: Case report
Mario Rene Pineda-De Paz, Massiel Madelin Rosario-Morel, Jose Guadalupe Lopez-Fuentes, Luis Ariel Waller-Gonzalez, Rodrigo Soto-Solis
World Journal of Gastrointestinal Endoscopy.2019; 11(7): 438. CrossRef
Georges-Paul Dieulafoy (1839–1911) de l’ulcération…
V. de Parades, J. -D. Zeitoun, N. Fathallah, D. Bouchard, G. Rahmi, J. -F. Contou
Côlon & Rectum.2017; 11(1): 49. CrossRef
Lower gastrointestinal bleeding due to rectal Dieulafoy’s lesion
Omar N Nadhem, Omar A Salh, Omar H Bazzaz
SAGE Open Medical Case Reports.2017;[Epub] CrossRef

7,893 View
74 Download
7 Web of Science
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