Update on the endoscopic management of peptic ulcer bleeding

被引：17

作者：

Holster I.L. ^{[1
]}

Kuipers E.J. ^{[2
]}

机构：

[1] Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam 3000 CA

[2] Department of Internal Medicine, Erasmus MC University Medical Centre, Rotterdam 3000 CA

来源：

Current Gastroenterology Reports | 2011年 / 13卷 / 6期

关键词：

Endoscopy; Management; Peptic ulcer; Pharmacotherapy; Review; Ulcer bleeding;

D O I：

10.1007/s11894-011-0223-7

中图分类号：

学科分类号：

摘要：

Upper gastrointestinal bleeding is the most common gastrointestinal emergency, with peptic ulcer as the most common cause. 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. The role of endoscopic therapy for ulcers with adherent clots remains to be elucidated. Ablative or mechanical therapies are superior to epinephrine injection alone in terms of prevention of rebleeding. The application of an ulcer-covering hemospray is a new promising tool. High dose proton pump inhibitors should be administered intravenously for 72 h after endoscopy in high-risk patients. Helicobacter pylori should be tested for in all patients with peptic ulcer bleeding and eradicated if positive. These recommendations have been captured in a recent international guideline. © 2011 The Author(s).

引用

页码：525 / 531

页数：6

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