[Bleeding peptic ulcers--concept for acute therapy].

Abstract

Acute ulcer bleeding still is a life-threatening event. The therapeutic goal is to establish intensity, activity and location of the bleeding and to assess primary hemostasis by consequent endoscopic therapy, also preventing recurrence significantly. With the injection method, primary hemostasis accounts for over 90% success. Also recurrent bleeding can be stopped to the same extent. Endoscopic doppler allows a qualitative and quantitative registration of potentially dangerous vessels on the ulcer base. Drug therapy does serve for the acute treatment to a lesser extent; it is more valid for the initiation of the conservative ulcer therapy. Surgical interventions therefore confined to risk patients in whom a primary hemostasis failed or the ulcer is located in a dangerous site, for instance in the back wall of the duodenal bulb.