title: Which types of non-bleeding visible vessels in gastric peptic ulcers should be treated by endoscopic hemostasis?
abstract: OBJECTIVE
  Because non-bleeding visible vessels (NBVV) of gastric peptic ulcers have the potential to re-bleed, endoscopic hemostatic treatment may be necessary during the first emergency endoscopy. However, not all NBVV re-bleed, and endoscopic hemostasis sometimes causes fatal side-effects. Therefore, we have evaluated the risk of re-bleeding from various NBVV in gastric peptic ulcers to determine which types should be treated by endoscopy to prevent re-bleeding.
  
  
  METHODS
  A total of 227 NBVV in 202 patients with gastric peptic ulcers that were endoscopically followed without endoscopic hemostatic procedures were classified by the following factors: vessel color, form, location of the NBVV in the ulcer crater, and location of the ulcer in the stomach. The re-bleeding rate was then analyzed for each type of NBVV.
  
  
  RESULTS
  Significantly high rates of re-bleeding were observed in cases with white, protruded and peripheral NBVV. In particular, white NBVV located in the peripheral zone of the ulcer crater were frequent re-bleeding sources. The location of the ulcer in the stomach was not a statistically significant factor in determining re-bleeding rates.
  
  
  CONCLUSIONS
  We found that white, protruded and peripherally located NBVV in gastric ulcers have a higher chance of re-bleeding if preventive endoscopic hemostatic procedures are not performed.
authors.affiliation: Departments of Gastrointestinal Endoscopy, Shimane Medical University, Shimane, Japan. amano@shimane-med.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Amano
authors.forename: N
authors.initials: N
authors.lastname: Moriyama
authors.forename: H
authors.initials: H
authors.lastname: Suetsugu
authors.forename: N
authors.initials: N
authors.lastname: Ishimura
authors.forename: T
authors.initials: T
authors.lastname: Imaoka
authors.forename: Y
authors.initials: Y
authors.lastname: Komazawa
authors.forename: H
authors.initials: H
authors.lastname: Fujishiro
authors.forename: S
authors.initials: S
authors.lastname: Ishihara
authors.forename: K
authors.initials: K
authors.lastname: Adachi
authors.forename: Y
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000517:prevention & control*; D012008:Recurrence; D016896:Treatment Outcome