ENDOSCOPIC HEMOSTASIS IN BLEEDING GASTROD UODENAL ULCERS

The mortality rate for peptic ulcer bleeding has remained constant for several decades, despite advances in surgery and intensive care, and this has given rise to an interest in therapeutic hemostatic endoscopy . Thus, endoscopy In the treatment of peptic ulcer hemorrhage would be undertaken with the aim of obtaining an early and precise diagnosis o f the hemorrhagic lesions, to arrest active bleeding and/or to prevent rebleeding. In the selection of patients justifying an endoscopic hem ostatic treatment, intervene clinical criteria (age, concomitant patho logies, current medication, hemodynamic parameters), endoscopic criter ia (active arterial bleeding, visible vessels). The most frequently em ployed methods are laser photocoagulation, thermal probe cauterisation , electrocoagulation and sclerotherapy. None of these methods have gai ned supremacy. There is consensus that sclerotherapy should be the met hod of reference (simple and inexpensive). Endoscopic methods are capa ble of arresting bleeding and constitute an alternative method to surg ery in cases of emergency. They should reduce recurrence of hemorrhage s, but nevertheless have no influence on the prognostic parameters whi ch are essentially clinical.