Abstract:
:Endoscopic Doppler ultrasound enables the reliable identification of vessels in the base of gastroduodenal ulcers. In a prospective study including 114 patients with acute ulcer bleeding, pulsed Doppler ultrasound was able to demonstrate superficial blood vessels in the ulcer base in 62% of 106 cases where complete Doppler assessment was possible (93%). Agreement between the endoscopic pattern of visible vessels and the Doppler ultrasound findings was attained in only 52% of the cases. Doppler positive ulcers (n = 66) were treated with injection therapy (if necessary, repeated), irrespective of their Forrest classification. Using such an approach, the rebleeding rate in this group decreased to less than 8% and none of the patients died of causes related to the hemorrhage. All Doppler negative ulcers (n = 40) healed without complications or the need for endoscopic treatment; among these were 11 cases with Forrest IIa and b. We conclude that endoscopic Doppler appears to be a valuable diagnostic procedure in the assessment of bleeding ulcers, thus modifying the Forrest classification. Our concept is that Doppler positive ulcers require local endoscopic treatment, whereas Doppler negative ulcers can be treated conservatively.
journal_name
Endoscopyjournal_title
Endoscopyauthors
Kohler B,Riemann JFdoi
10.1055/s-2007-1010296subject
Has Abstractpub_date
1993-03-01 00:00:00pages
219-23issue
3eissn
0013-726Xissn
1438-8812journal_volume
25pub_type
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