title: Management of Patients with Rebleeding.
abstract: Peptic ulcer bleeding is a common emergency. Management of ulcer bleeding requires prompt risk stratification, initiation of pharmacotherapy, and timely evaluation for endoscopy. Although endoscopy can achieve primary hemostasis in more than 90% of peptic ulcer bleeding, rebleeding may occur in up to 15% of patients after therapeutic endoscopy and is associated with heightened mortality. Early identification of high-risk patients for rebleeding is important. Depending on bleeding severity and center availability, patients with rebleeding may be managed by second endoscopy, transarterial angiographic embolization, or surgery. This article reviews the current management of peptic ulcers with an emphasis on rebleeding.
authors.affiliation: State Key Laboratory of Digestive Disease, Faculty of Medicine, Institute of Digestive Disease, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China.
authors.forename: Sunny H
authors.initials: SH
authors.lastname: Wong
authors.affiliation: State Key Laboratory of Digestive Disease, Faculty of Medicine, Institute of Digestive Disease, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China. Electronic address: jjysung@cuhk.edu.hk.
authors.forename: Joseph J Y
authors.initials: JJ
authors.lastname: Sung
mesh_terms: D019468:Disease Management; D004621:Embolization, Therapeutic / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D012008:Recurrence
keywords: Angiographic embolization; Endoscopy; Peptic ulcer; Rebleeding; Surgery