title: [The value of routine second-look endoscopy in the management of acute gastroduodenal ulcer bleeding].
abstract: The role of routine second-look endoscopy in the management of patients with acute peptic ulcer bleeding is controversial. A more precise identification of higher risk patient group, based on both clinical and endoscopic criteria, is needed to determine whether there are high-risk patients who may benefit from this management strategy.
  
  
  OBJECTIVE
  Or aim was to find out whether scheduled second-look endoscopy has any beneficial effect in the clinical outcome.
  
  
  METHODS
  Both endoscopic and clinical data were analyzed in 274 acute gastroduodenal ulcer bleeding patients. The need for repeated endoscopic haemostatic intervention was used as a measure to evaluate the potential beneficial effect of the second look endoscopy. Patients were categorized according to the Forrest classification detected during the emergency endoscopy.
  
  
  RESULTS
  In the subgroup of actively bleeding patients (Forrest Ia, Ib) a second endoscopic haemostasis was performed in 23.8% of cases. In the patient subgroup with visible vessel ulcers (Forrest IIa) and in those with adherent clot covered ulcers (Forrest IIb) the needs for a repeated haemostasis were 13.0% and 13.3% respectively. Despite the not statistically significant differences, remarkable clinical impact was noted favoring scheduled second look endoscopy in patients with initially active ulcer bleeding.
  
  
  CONCLUSIONS
  In the light of the retrospective study results it may be concluded that the scheduled second look endoscopy strategy offers a beneficial clinical outcome for selected patients estimated to be a very high risk of re-bleeding following the initial endoscopic therapy for active bleeding.
authors.affiliation: Marosvásárhelyi Orvosi és Gyógyszerészeti Egyetem II. Belgyógyászati Klinika Marosvásárhely.
authors.forename: Katalin
authors.initials: K
authors.lastname: Szocs
authors.forename: Tibor
authors.initials: T
authors.lastname: Kárász
authors.forename: Hussam
authors.initials: H
authors.lastname: Saleh
authors.forename: Andrea
authors.initials: A
authors.lastname: Szabó
authors.forename: Mihály
authors.initials: M
authors.lastname: Csöndes
authors.forename: Nóra
authors.initials: N
authors.lastname: Dancs
authors.forename: Márta
authors.initials: M
authors.lastname: Jánoki
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Horváth
authors.forename: István
authors.initials: I
authors.lastname: Rácz
mesh_terms: D000208:Acute Disease; D004384:Duodenoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D005773:Gastroscopy; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome