title: Improved characterization of visible vessels in bleeding ulcers by using magnification endoscopy: results of a pilot study.
abstract: BACKGROUND
  Not all exposed vessels carry the same risk of recurrent bleeding, and sometimes endoscopic therapy may not be warranted in the setting of profound acid inhibition therapy.
  
  
  OBJECTIVE
  To investigate the role of magnification endoscopy (ME) in improving the characterization of exposed vessels in ulcer hemorrhage.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Single-center teaching hospital.
  
  
  METHODS
  Diagnostic accuracy and safety of ME in patients with bleeding peptic ulcers.
  
  
  RESULTS
  A total of 43 patients were studied. Exposed vessels were initially categorized as high risk (protuberant, translucent, or pale) in 25 and low risk (nonprotruding through the ulcer floor, pigmented, or dark red) in 18 cases. ME was subsequently performed, and the operator was asked to reclassify the vessel into 1 of these 2 categories. A magnified view provided a clear image of the vessel and allowed visualization of the artery, the site of rupture, and the presence of a clot plugging the hole. In 6 cases previously categorized as low risk, ME clearly showed the 2 ends of the vessel, the longitudinal tear in the vessel wall, and a protuberant aspect that was not seen with standard view. The lesion was then reclassified as high risk (diagnostic gain 33%). The mean procedure time for ME inspection was 7 +/- 4 minutes. No complications occurred.
  
  
  CONCLUSIONS
  Absence of controls.
  
  
  CONCLUSIONS
  In patients with peptic ulcer bleeding and exposed vessels, ME allows clear visualization of the vessel wall and provides detailed clues to further characterize the lesion.
authors.affiliation: Division of Gastroenterology, Hospital A. Maresca, Torre del Greco, Italy. livio.cipolletta@alice.it
authors.forename: Livio
authors.initials: L
authors.lastname: Cipolletta
authors.forename: Maria Antonia
authors.initials: MA
authors.lastname: Bianco
authors.forename: Raffaele
authors.initials: R
authors.lastname: Salerno
authors.forename: Antonio
authors.initials: A
authors.lastname: Prisco
authors.forename: Riccardo
authors.initials: R
authors.lastname: Marmo
authors.forename: Fabio
authors.initials: F
authors.lastname: Cipolletta
authors.forename: Roberto
authors.initials: R
authors.lastname: Piscopo
authors.forename: Stefano
authors.initials: S
authors.lastname: Sansone
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rotondano
mesh_terms: D001808:Blood Vessels / Q000473:pathology*; D004381:Duodenal Ulcer; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007413:Intestinal Mucosa / Q000098:blood supply*; D010438:Peptic Ulcer Hemorrhage / Q000473:pathology*; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D013276:Stomach Ulcer