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Acute Ulcer Bleeding (A Prospective Randomized Trial to Compare Doppler and Forrest Classifications in Endoscopic Diagnosis and Therapy)

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Abstract

The aim of our prospective randomized studyinvolving 100 patients was to investigate whetherDoppler ultrasound can be used to select patients atrisk for ulcer rebleeding. Ulcers in the Forrest group classified as having a visible vessel or a clotwere treated prophylactically by injection withepinephrine solution. In the Doppler group, in contrast,only ulcers with a positive Doppler signal were treated endoscopically. In the Doppler group, rebleedsoccurred significantly less frequently (2%, P < 0.03)than in the Forrest group (14%). Emergency surgery wasonly necessary in the Forrest group (0% vs 5%; P =0.02). Bleeding-related mortality was 0% and 4% (P =0.15) and the overall mortality 0% and 10% (P = 0.02),in the Doppler and Forrest groups, respectively. Theseresults appear to show that Doppler-based injection treatment is superior to endoscopictreatment based exclusively on the Forrestclassification. In our study, Doppler-based localendoscopic treatment reduced the danger of a rebleed andthus the number of emergency operations and the overallmortality.

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Authors
  1. Bernd Kohler
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  2. Matthias Maier
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  3. Claus Benz
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  4. Jurgen F. Riemann
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Kohler, B., Maier, M., Benz, C. et al. Acute Ulcer Bleeding (A Prospective Randomized Trial to Compare Doppler and Forrest Classifications in Endoscopic Diagnosis and Therapy). Dig Dis Sci 42, 1370–1374 (1997). https://doi.org/10.1023/A:1018877602113

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  • DOI: https://doi.org/10.1023/A:1018877602113

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