Prediction of rebleeding in peptic ulcers by visual stigmata and endoscopic Doppler ultrasound criteria.

Abstract:

:Following peptic ulcer hemorrhage, the ability to accurately determine those patients at highest risk of rebleeding relies on clinical and endoscopic criteria which are accurate in only a variable proportion of cases. In this study we have assessed prediction of rebleeding in peptic ulcers using a transendoscopic vascular detector (TVD) to compare the presence of a positive Doppler signal in relation to an ulcer base with visual stigmata of recent hemorrhage (SRH). Of 711 patients endoscoped for upper GI hemorrhage over an 18-month period 180 (25%) were found to have a peptic ulcer. One hundred and twenty-four had either minor or no SRH at the time of endoscopy, and none of these patients rebled. Fifty-six patients had a single peptic ulcer with either active hemorrhage, a visible vessel or adherent clot, and 22 were entered into the trial. Overall, 9 patients (41%) in this group rebled. Considering prediction of rebleeding, visible vessels had a sensitivity of 89% and specificity of 92% compared with a positive Doppler signal sensitivity of 87% and specificity of 86%. These results suggest that the TVD can predict rebleeding in peptic ulcers with an accuracy similar to that of endoscopic identification of a visible vessel.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Fullarton GM,Murray WR

doi

10.1055/s-2007-1012795

subject

Has Abstract

pub_date

1990-03-01 00:00:00

pages

68-71

issue

2

eissn

0013-726X

issn

1438-8812

journal_volume

22

pub_type

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