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Previous Volume 331:717-727 September 15, 1994 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Peptic ulcer is the most common cause of acute hemorrhage in the upper gastrointestinal tract, accounting for about 50 percent of cases^{1,2,3,4,5,6,7,8,9,10,11,12,13,14}. There are approximately 150,000 hospitalizations per year in the United States for evaluation and treatment of bleeding ulcers (based on 1985 estimates and excluding federal hospitals)¹⁵. Although hospitalization and surgery for uncomplicated ulcers have decreased in the United States and Europe over the past 20 to 30 years, the number of hospital admissions for hemorrhage associated with ulcers has remained relatively unchanged^15,16,17. It is noteworthy that the incidence of bleeding ulcers appears to rise in . . . [Full Text of this Article]

Pathogenesis

Histologic Features

Predisposing Factors

Clinical Presentation

Clinical Prognostic Factors

Prognostic Features at Endoscopy

Initial Management

Treatment of Acute Bleeding Episodes

Medical Therapy

Endoscopic Therapy

Surgical Therapy

Angiographic Therapy

Prevention of Recurrent Bleeding

Medical Therapy

Surgical Therapy

Source Information

From the Department of Medicine, University of Southern California School of Medicine, and the Los Angeles County and University of Southern California Medical Center, Los Angeles (L.L.); and the University of Texas Southwestern Medical School and the Medical Service, Dallas Veterans Affairs Medical Center, Dallas (W.L.P.).

Address reprint requests to Dr. Peterson at Digestive Diseases (111B1), Dallas VA Medical Center, 4500 S. Lancaster Rd., Dallas, TX 75216.

References

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• Robins, G G, Sarwar, M S, Armstrong, M, Denyer, M E, Bush, S, Hassan, T, Everett, S M (2007). Evaluation of the need for endoscopy to identify low-risk patients presenting with an acute upper gastrointestinal bleed suitable for early discharge. Postgrad. Med. J. 83: 768-772 [Abstract] [Full Text]  
• Rivkin, K., Lyakhovetskiy, A. (2005). Treatment of nonvariceal upper gastrointestinal bleeding. Am J Health Syst Pharm 62: 1159-1170 [Abstract] [Full Text]  
• Devlin, J. W. (2005). Introduction. Am J Health Syst Pharm 62: S2-S3 [Full Text]  
• Olsen, K. M. (2005). Use of acid-suppression therapy for treatment of non-variceal upper gastrointestinal bleeding. Am J Health Syst Pharm 62: S18-S23 [Abstract] [Full Text]  
• Leontiadis, G. I, Sharma, V. K, Howden, C. W (2005). Systematic review and meta-analysis of proton pump inhibitor therapy in peptic ulcer bleeding. BMJ 330: 568- [Abstract] [Full Text]  
• (2004). Proton pump inhibitors for acute upper GI bleeding. DTB 42: 41-43 [Abstract] [Full Text]  
• Barkun, A., Bardou, M., Marshall, J. K., for the Nonvariceal Upper GI Bleeding Consensus Co, (2003). Consensus Recommendations for Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding. ANN INTERN MED 139: 843-857 [Abstract] [Full Text]  
• Chiu, P W Y, Lam, C Y W, Lee, S W, Kwong, K H, Lam, S H, Lee, D T Y, Kwok, S P Y (2003). Effect of scheduled second therapeutic endoscopy on peptic ulcer rebleeding: a prospective randomised trial. Gut 52: 1403-1407 [Abstract] [Full Text]  
• Liu, C.-C., Lee, C.-L., Chan, C.-C., Tu, T.-C., Liao, C.-C., Wu, C.-H., Chen, T.-K. (2003). Maintenance Treatment Is Not Necessary After Helicobacter pylori Eradication and Healing of Bleeding Peptic Ulcer: A 5-Year Prospective, Randomized, Controlled Study. Arch Intern Med 163: 2020-2024 [Abstract] [Full Text]  
• Sung, J. J.Y., Chan, F. K.L., Lau, J. Y.W., Yung, M.-Y., Leung, W.-K., Wu, J. C.Y., Ng, E. K.W., Chung, S.C S. (2003). The Effect of Endoscopic Therapy in Patients Receiving Omeprazole for Bleeding Ulcers with Nonbleeding Visible Vessels or Adherent Clots: A Randomized Comparison. ANN INTERN MED 139: 237-243 [Abstract] [Full Text]  
• Jensen, D. M. (2003). Treatment of Patients at High Risk for Recurrent Bleeding from a Peptic Ulcer. ANN INTERN MED 139: 294-295 [Full Text]  
• Spiegel, B. M.R., Targownik, L., Dulai, G. S., Gralnek, I. M. (2003). The Cost-Effectiveness of Cyclooxygenase-2 Selective Inhibitors in the Management of Chronic Arthritis. ANN INTERN MED 138: 795-806 [Abstract] [Full Text]  
• Mahadeva, S, Linch, M, Hull, M (2002). Variable use of endoscopic haemostasis in the management of bleeding peptic ulcers. Postgrad. Med. J. 78: 347-351 [Abstract] [Full Text]  
• Libby, E. D. (2000). Omeprazole to Prevent Recurrent Bleeding after Endoscopic Treatment of Ulcers. NEJM 343: 358-359 [Full Text]  
• De Ledinghen, V, Heresbach, D, Fourdan, O, Bernard, P, Liebaert-Bories, M P, Nousbaum, J B, Gourlaouen, A, Becker, M C, Ribard, D, Ingrand, P, Silvain, C, Beauchant, M (1999). Anti-inflammatory drugs and variceal bleeding: a case-control study. Gut 44: 270-273 [Abstract] [Full Text]