Peptic ulcer disease endoscopy

Jump to navigation Jump to search

Peptic ulcer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Peptic Ulcer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Upper GI Endoscopy

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Endoscopic management
Surgical management

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

2017 ACG Guidelines for Peptic Ulcer Disease

Guidelines for the Indications to Test for, and to Treat, H. pylori Infection

Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America

Guidlines for factors that predict the successful eradication when treating H. pylori infection

Guidelines to document H. pylori antimicrobial resistance in the North America

Guidelines for evaluation and testing of H. pylori antibiotic resistance

Guidelines for when to test for treatment success after H. pylori eradication therapy

Guidelines for penicillin allergy in patients with H. pylori infection

Guidelines for the salvage therapy

Peptic ulcer disease endoscopy On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Peptic ulcer disease endoscopy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Peptic ulcer disease endoscopy

CDC on Peptic ulcer disease endoscopy

Peptic ulcer disease endoscopy in the news

Blogs on Peptic ulcer disease endoscopy

to Hospitals Treating Peptic ulcer

Risk calculators and risk factors for Peptic ulcer disease endoscopy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Therapeutic endoscopy is used to treat bleeding ulcer and recurrent ulcer.The second endoscopy is done 24 hours after endoscopic therapy to check for bleeding.If there is bleeding after second look endoscopy next step is surgery or interventional radiology with transcatheter arterial embolization is done

Endoscopic therapy[1]

Indications for endoscopic therapy

  • Patients with active spurting or oozing bleeding or a non-bleeding visible vessel
  • Patients with an adherent clot resistant to vigorous irrigation

Endoscopic therapy can be done by following methods:[2]

Endoscopic and Medical Therapy for Bleeding Ulcer

Approach to endoscopic therapy:*

 
 
 
 
 
 
 
 
Bleeding ulcer
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Endoscopy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Active bleeding
or non-bleeding
visible vessel
 
 
 
 
Adherent clot
 
 
 
 
Flat spot
or clean base
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Endoscopic therapies:
•Injection therapy
•Thermal coagulation
•Mechanical therapy
•Combined therapy
•Hemospray
 
 
 
 
May consider
Endoscopic therapies:
•Injection therapy
•Thermal coagulation
•Mehanical therapy
•Combined therapy
•Hemospray
 
 
 
 
No endoscopic therapy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PPI or infusions
 
 
 
 
 

*Adopted:American college of gasteroenterology[11]

Second look endoscopy

References

  1. Laine L, McQuaid KR (2009). "Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials". Clin. Gastroenterol. Hepatol. 7 (1): 33–47, quiz 1–2. doi:10.1016/j.cgh.2008.08.016. PMID 18986845.
  2. Cook DJ, Guyatt GH, Salena BJ, Laine LA (1992). "Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis". Gastroenterology. 102 (1): 139–48. PMID 1530782.
  3. Park CH, Lee SJ, Park JH, Park JH, Lee WS, Joo YE, Kim HS, Choi SK, Rew JS, Kim SJ (2004). "Optimal injection volume of epinephrine for endoscopic prevention of recurrent peptic ulcer bleeding". Gastrointest. Endosc. 60 (6): 875–80. PMID 15605000.
  4. Rutgeerts P, Rauws E, Wara P, Swain P, Hoos A, Solleder E, Halttunen J, Dobrilla G, Richter G, Prassler R (1997). "Randomised trial of single and repeated fibrin glue compared with injection of polidocanol in treatment of bleeding peptic ulcer". Lancet. 350 (9079): 692–6. PMID 9291903.
  5. Chung SC, Leong HT, Chan AC, Lau JY, Yung MY, Leung JW, Li AK (1996). "Epinephrine or epinephrine plus alcohol for injection of bleeding ulcers: a prospective randomized trial". Gastrointest. Endosc. 43 (6): 591–5. PMID 8781939.
  6. Scharnke W, Hust MH, Braun B, Schumm W (1997). "[Complete gastric wall necrosis after endoscopic sclerotherapy for a gastric ulcer with visible arterial stump]". Dtsch. Med. Wochenschr. (in German). 122 (19): 606–9. doi:10.1055/s-2008-1047662. PMID 9182025.
  7. 7.0 7.1 Lin HJ, Tseng GY, Perng CL, Lee FY, Chang FY, Lee SD (1999). "Comparison of adrenaline injection and bipolar electrocoagulation for the arrest of peptic ulcer bleeding". Gut. 44 (5): 715–9. PMC 1727515. PMID 10205211.
  8. Ohta S, Yukioka T, Ohta S, Miyagatani Y, Matsuda H, Shimazaki S (1996). "Hemostasis with endoscopic hemoclipping for severe gastrointestinal bleeding in critically ill patients". Am. J. Gastroenterol. 91 (4): 701–4. PMID 8677932.
  9. Scapa E (1997). "Treating gastrointestinal bleeding with endoscopic hemoclips". Surg Laparosc Endosc. 7 (2): 94–6. PMID 9109234.
  10. Sung JJ, Luo D, Wu JC, Ching JY, Chan FK, Lau JY, Mack S, Ducharme R, Okolo P, Canto M, Kalloo A, Giday SA (2011). "Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding". Endoscopy. 43 (4): 291–5. doi:10.1055/s-0030-1256311. PMID 21455870.
  11. "Management of Patients with Ulcer Bleeding | American College of Gastroenterology".
  12. Chiu PW, Lam CY, Lee SW, Kwong KH, Lam SH, Lee DT, Kwok SP (2003). "Effect of scheduled second therapeutic endoscopy on peptic ulcer rebleeding: a prospective randomised trial". Gut. 52 (10): 1403–7. PMC 1773815. PMID 12970130.
  13. Villanueva C, Balanzó J, Torras X, Soriano G, Sáinz S, Vilardell F (1994). "Value of second-look endoscopy after injection therapy for bleeding peptic ulcer: a prospective and randomized trial". Gastrointest. Endosc. 40 (1): 34–9. PMID 8163132.