GI Bleeding

Question 1

Forrest classification

Answer 1

I active bleeding
Ia spurting hemorrhage (treat)
Ib oozing hemorrhage (treat)

II signs of recent hemorrhage
IIa non bleeding visible vessel (treat)
IIb adherent blood clot
III clean ulcer base without active bleeding

Question 2

Indication to surgery

Answer 2

Failure of endoscopic therpy in case of active bleeding
Early recurrence
Initial hypotension
Big ulcus
Posterior ulcus duodeni
High risk patient who would not tolerate a recurrence

Question 3

Bleeding in case of portal hypertension

Answer 3

Ceftriaxone 1g/d for 5 days

Options :

• sengstaken blakemore
• TIPS