October 23rd, 2014
Clip, Burn, Inject, or All Three? How Do You Treat Ulcer Bleeding?
As endoscopists, we have all sorts of tools to treat ulcer bleeding or other gastrointestinal bleeding, such as injection with epinephrine and thermal coaptive coagulation with heater probes or multipolar electrodes like the Gold probe. More recently, a myriad of clips have become available for use. It seems to me that both operator and ulcer characteristics determine what is used in any given situation.
Take the case of a duodenal ulcer that is actively oozing at the apex of the bulb.
- What approach would you take to control bleeding?
- What if it were spurting?
- What if it only had a visible vessel?
- What if it had an adherent clot?
- Would you take the same approach in treating a gastric ulcer?
I look forward to the dialogue.