UPDATE ON ENDOSCOPIC MANAGEMENT OF PEPTIC ULCER BLEEDING

2012 ◽  
pp. 5-11
Author(s):  
Ngoc Quy Hue Dang ◽  
Van Huy Tran
Keyword(s):  
Peptic Ulcer ◽  
High Risk ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Endoscopic Therapy ◽  
Active Bleeding ◽  
Ulcer Bleeding ◽  
Endoscopic Management ◽  
High Dose ◽  
Peptic Ulcer Bleeding

Peptic ulcer bleeding is a common medical emergency and still a potentially fatal condition. It is the best managed using a multidisciplinary approach by a team with medical, endoscopic and surgical expertise. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of presentation. Endoscopic therapy is indicated for patients with high-risk stigmata, in particular those with active bleeding and visible vessels. A combination of proton pump inhibitors and endoscopic therapy (using a combination of injection and mechanical hemostasis) offers the best chance of hemostasis for those with active bleeding ulcers. The application of an ulcer-covering hemospray is a new promising tool. High dose proton pump inhibitors should be administered intravenously for 72 h in high-risk patients. Helicobacter pylori should be tested for in all patients with peptic ulcer bleeding and eradicated if positive

scholarly journals A Real World Report on Intravenous High-Dose and Non-High-Dose Proton-Pump Inhibitors Therapy in Patients with Endoscopically Treated High-Risk Peptic Ulcer Bleeding

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Lung-Sheng Lu ◽  
Sheng-Chieh Lin ◽  
Chung-Mou Kuo ◽  
Wei-Chen Tai ◽  
Po-Lin Tseng ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
High Risk ◽  
Proton Pump ◽  
Real World ◽  
Case Control ◽  
Ulcer Bleeding ◽  
Control Group ◽  
High Dose ◽  
Peptic Ulcer Bleeding ◽  
Treatment Control

Background and Study Aims. The optimal dose of intravenous proton-pump inhibitor (PPI) therapy for the prevention of peptic ulcer (PU) rebleeding remains controversial. This study aimed to understand the real world experiences in prescribing high-dose PPI and non-high-dose PPI for preventing rebleeding after endoscopic treatment of high-risk PU.Patients and Methods. A total of 220 subjects who received high-dose and non-high-dose pantoprazole for confirmed acute PU bleeding that were successfully treated endoscopically were enrolled. They were divided into rebleeding (n=177) and non-rebleeding groups (n=43). Randomized matching of the treatment-control group was performed. Patients were randomly selected for non-high-dose and high-dose PPI groups (n=44in each group).Results. Univariate analysis showed, significant variables related to rebleeding were female, higher creatinine levels, and higher Rockall scores (≧6). Before case-control matching, the high-dose PPI group had higher creatinine level, higher percentage of shock at presentation, and higher Rockall scores. After randomized treatment-control matching, no statistical differences were observed for rebleeding rates between the high-dose and non-high-dose groups after case-control matching.Conclusion. This study suggests that intravenous high-dose pantoprazole may not be superior to non-high-dose regimen in reducing rebleeding in high-risk peptic ulcer bleeding after successful endoscopic therapy.

EFFICACY OF ENDOSCOPIC HEMOCLIPS AND INTERMITTENT INTRAVENOUS PPI IN PEPTIC ULCER BLEEDING

2019 ◽  
pp. 40-44
Author(s):  
Van Huy Tran ◽  
Duy Lieu Dinh
Keyword(s):  
Peptic Ulcer ◽  
Key Words ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Forrest Classification

Background: Efficacy of continuous intravenous proton- pump inhibitors (IV PPI) and hemoclips alone was proved, but data about combination of an application of endoscopy clips and intermittent IV PPI in Vietnam was still limited. This study aimed to assess the efficacy of endoscopy hemoclip combined with intermittent IV PPI in the patients of peptic ulcer bleeding. Patients and methods: 34 patients diagnosed as peptic ulcer bleeding, having Forrest classification of Ia, Ib, IIa and IIb, were enrolled. Esomeprazole was administered as 80 mg IV bolus followed by intermittent IV injection of 40 mg/8h during 72h. Results: Immediate hemostasis was achieved in all 34 patients. Only 1 patient (2.9%) had early rebleeding. No severe complications was found in this study. Conclusion: Combination of endoscopy hemoclips and intermittent PPI showed effective, safe in patients of peptic ulcer bleeding. Key words: Peptic ulcer bleeding, intermittent PPI, endoscopy hemoclip

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