Endoscopic Grading of Peptic Ulcer Bleeding

Endoscopic Grading of Peptic Ulcer Bleeding
Endoscopic Grading of Peptic Ulcer Bleeding
Forrest classification is a classification of upper gastrointestinal hemorrhage used for purposes of comparison and in selecting patients for endoscopic treatment. ————————————————-

Forrest classification
Acute hemorrhage
* Forrest I a (Spurting hemorrhage)
* Forrest I b (Oozing hemorrhage)
Signs of recent hemorrhage
* Forrest II a (Visible vessel)
* Forrest II b (Adherent clot)
* Forrest II c (Hematin on ulcer base)
Lesions without active bleeding
* ————————————————-
Forrest III (Lesions without signs of recent hemorrhage)
————————————————-
Application
Forrest classification is instrumental when stratifying patients with upper gastrointestinal hemorrhage into high and low risk categories for mortality. It is also a significant method of prediction of the risk of rebleeding and very often is used for evaluation of the endoscopic intervention modalities[3]. A prospective controlled study revealed that “Forrest criteria are essential for proper planning of endoscopic therapy and urgent surgery in bleeding peptic ulcers.”

WRITE THIS ESSAY FOR ME

Tell us about your assignment and we will find the best writer for your paper.

Get Help Now!

Presence of shock and type 1 bleeding peptic ulcer carries a rebleed risk of 80% and presence of non-bleeding visible vessel predisposes the patient to a 50% risk of further bleed. Ulcer with a clean base (type 3) and ulcers with red or dark blue spots (type 2c) rarely re-bleed during hospitalization. Bleeding peptic ulcer in the posterior duodenal bulb and proximal gastric lesser curve are located near major vessels and are associated with higher re-bleed rates and are more likely to cause death

Predictors of Mortality

Patient characteristic that have been reported to be associated with increase in mortality are:

Age, onset of bleeding, co-morbidity, hypotension and shock at presentation, fresh bleed in Ryle’s tube aspirate, haemoglobin level at presentation and…