[Treatment of bleeding gastroduodenal ulcer].
Of 1700 patients (31/100,000 inhabitants) with endoscopically verified bleeding gastroduodenal ulcer registered yearly in Denmark, 20% rebled, 8% had surgery, and 11% died. Forrest Ia-IIb ulcers are treated endoscopically with combined or thermal methods. Monotherapy with epinephrine is insufficient. The effect of tranexamic acid is uncertain. Proton pump inhibitors reduce rebleeding and surgery but not mortality. H. Pylori should be diagnosed and eradicated in order to reduce recurrence. Second look gastroscopy should be used for selected cases only. Treatment by dedicated teams may be beneficial.
Adamsen
Sven
S
Herlev Hospital, Kirurgisk Gastroenterologisk Afdeling D, Herlev. sven.adamsen@heh.regionh.dk
de Muckadell
Ove B Schaffalitzky
OB
D000863:Antacids / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004384:Duodenoscopy; D004621:Embolization, Therapeutic; D004837:Epinephrine / Q000627:therapeutic use; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D054328:Proton Pump Inhibitors; D012008:Recurrence; D013276:Stomach Ulcer / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014148:Tranexamic Acid / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000863:Antacids; D000933:Antifibrinolytic Agents; D054328:Proton Pump Inhibitors; D014662:Vasoconstrictor Agents; D014148:Tranexamic Acid; D004837:Epinephrine