Nonvariceal Upper Gastrointestinal Bleeding
Nonvariceal upper GI bleeding is a major source of morbidity and mortality as well as of healthcare expenditure. There have been considerable advances in the treatment of upper GI bleeding, particularly in the form of endoscopic therapeutic modalities. Endoscopists should be familiar with most of these techniques and comfortable performing them in practice. We review the various endoscopic therapies used to treat acute nonvariceal upper GI bleeding.
KeywordsUpper GI bleeding Endoscopy Endoscopic therapy Epinephrine injection Bipolar cautery Band ligation Argon plasma coagulation Nonvariceal
This video demonstrates endoscopic techniques for hemostasis. In the first patient, bipolar cautery is used to treat a duodenal ulcer in a difficult location. In the second patient, a Doppler probe is first used to confirm a clean-based ulcer without a vessel. A superficial duodenal ulcer with a bleeding visible vessel is treated with the application of a hemoclip. In the third patient, an angioectasia in the third portion of the duodenum is visualized using a side-viewing duodenoscope and treated with APC and the hemoclips. The final patient has a large bleeding gastric tumor that is treated with APC therapy. (MP4 448,075 kb)
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