Is Routine Second-Look Endoscopy Necessary for All Bleeding Peptic Ulcers?.
- Author:
Eun Ju LEE
1
;
Sang Won LEE
;
Tae Dong KIM
;
Kook Hyun KIM
;
Hee Ju OH
;
Byeong Ik JANG
;
Tae Nyeun KIM
;
Moon Kwan CHUNG
Author Information
1. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. tnk@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Bleeding peptic ulcer;
Endoscopic hemostasis;
Second-look endoscopy
- MeSH:
Classification;
Emergencies;
Endoscopy*;
Follow-Up Studies;
Hemorrhage*;
Hemostasis;
Hemostasis, Endoscopic;
Humans;
Ligation;
Peptic Ulcer*;
Prospective Studies;
Retreatment
- From:Korean Journal of Gastrointestinal Endoscopy
2003;26(1):1-7
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Second-look endoscopy is generally performed to prevent rebleeding in patients with bleeding peptic ulcers. However, considering recent technologic advances of endoscopic hemostasis and decreasing rate of rebleeding, a small benefit with second-look endoscopy is suggested. Prospective study was carried out to evaluate the efficacy of second-look endoscopic examinations. METHODS AND RESULTS: One hundred thirty six patients with bleeding from peptic ulcer were included. Emergency endoscopic treatments consisting of the injection of hypertonic saline-epinephrine (HSE), band ligation and/or clipping were performed in patients with Forrest class I-IIb. They were scheduled to receive second-look endoscopy in 48 hours after initial endoscopy. Nine patients (6.6%) received endoscopic retreatment during second-look endoscopy and emergency endoscopic retreatment was required before scheduled endoscopy in six patients (4.4%) because of the evidence of rebleeding. Factors influencing retreatment were Forrest classification of initial endoscopy and methods of hemostasis. None of the patients with Forrest class IIb-III and the patients receiving endoscopic band ligation or clipping on initial endoscopy required retreatment during follow-up endoscopy. CONCLUSION: Routine second-look endoscopy may not be recommended after initial successful endoscopic treatment of peptic ulcer bleeding, especially in case of Forrest class IIb, IIc or III and in the patients treated with band ligation or clipping.
