| Theme |
Endoscopic Treatment of Upper Gastrointestine: Current Status and Clinical Problems |
| Title |
Characteristics of and Countermeasures for Bleeding Peptic Ulcers when Endoscopic Hemostasis is Difficult |
| Author |
Hitoshi Sekine |
Department of Gastroenterology, Tohoku University Hospital |
| Author |
Shuich Ohara |
Department of Gastroenterology, Tohoku University Hospital |
| [ Summary ] |
Endoscopic hemostasis has significantly improved the outcome for patients with bleeding peptic ulcers, but technical difficulties have been experienced in some cases. One of the reasons for this is the angle of approach is tangential. It has been suggested that changing the endoscopic angle could help to solve this problem. The presence of a large visible vessel is another cause of the failure of endoscopic hemostasis. In such cases, the most suitable method, including some combination of endoscopic hemostasis, may be necessary. Recurrent bleeding after initial hemostasis is often observed in patients with large or multiple ulcers. Because such patients frequently have significant general medical diseases, they should be appropriately managed at the same time. The characteristics of the technically difficult cases are appreciated, and it is necessary to work for improvements in endoscopic technique. |