Peptic Ulcer

Bleeding from a peptic ulcer remains the most common source of upper GI bleed accounting for greater than 50%. This can be controlled approximately 94% of the time using endoscopic techniques. Visualization of an ulcer itself can be an important predictor of rebleed. Ulcers have four recognized appearances: clean base; a flat, pigmented spot, which at times may be purple; an adherent clot; a visible vessel; or active bleeding. These are all considered to have an increased risk of hemorrhage. A clean ulcer base rarely bleeds; a flat pigmented base will bleed in about 10% of patients; an adherant nonbleeding clot rebleeds in about 20% of patients; and a visible vessel carries about a 40-80% rebleed rate.

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