Hemostasis of Acute Nonvariceal Upper Gastrointestinal Bleeding

  • Amir Klein
  • Ian M. GralnekEmail author


Peptic ulcers, mucosal erosions, erosive esophagitis, Mallory-Weiss tear, angiodysplasias, gastric antral vascular ectasia, and tumors are common causes of non-variceal upper gastrointestinal bleeding (NVUGIB). Endoscopy is an integral part of the management algorithm for NVUGIB. Endoscopic modalities that have proven to be effective in achieving primary hemostasis and preventing rebleeding include injection therapy, thermal therapies, and mechanical devices, such as clips and bands. The identification of bleeding lesions that are suitable for endoscopic hemostasis, careful selection of specific device(s) for a particular lesion, and operator familiarity and dexterity in handling hemostatic devices are principal determinants for a successful endoscopic outcome.

This chapter includes supplementary videos.


Upper gastrointestinal bleeding Endoscopic hemostasis Non-variceal upper gastrointestinal bleeding Peptic ulcer bleeding Dieulafoy lesion Mallory-Weiss tear Vascular ectasias Gastric antral vascular ectasia 

Supplementary material

Video 11.1

Actively bleeding gastric ulcer treated with epinephrine injection and heater probe coagulation (MP4 47696 kb)

Video 11.2

Gastric antral vascular ectasia treated with argon plasma coagulation (MP4 22551 kb)

Video 11.3

Actively oozing gastric ulcer treated with clip placement (MP4 14076 kb)

Video 11.4

Salvage over-the-scope clip placement for recurrent post-polypectomy duodenal bleeding (MP4 14046 kb)

Video 11.5

Gastric Dieulafoy lesion treated with endoscopic band ligation (MP4 20681 kb)

Video 11.6

Persistent peptic ulcer bleeding treated with a hemostatic spray (MP4 16773 kb)

Video 11.7

Ulcer and bleeding stigmata unsuitable for endoscopic therapy (MP4 14764 kb)

Video 11.8

Mallory-Weiss tear treated with clip placement (MP4 24503 kb)

Video 11.9

Endoscopic management of a peptic ulcer with an adherent clot (MP4 22987 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of GastroenterologyRambam Health Care CampusHaifaIsrael
  2. 2.Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael
  3. 3.Department of Gastroenterology and HepatologyHa’Emek Medical CenterAfulaIsrael

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