BACKGROUND AND AIMS: For more than 4 decades endoscopists have relied on @entity1066 stigmata for risk stratification and as a guide to hemostasis. None used arterial blood flow underneath stigmata to predict outcomes. For @entity1 with severe peptic @entity1066 (PUB), we used a Doppler endoscopic probe (DEP) for (1) detection of blood flow underlying stigmata of recent @entity548 (SRH), (2) quantitating rates of residual arterial blood flow under SRH after visually directed standard endoscopic treatment, and (3) comparing risks of rebleeding and actual 30-day rebleed rates for spurting @entity548 (Forrest [F] IA) and oozing @entity548 (F IB). METHODS: Prospective cohort study of 163 consecutive @entity1 with severe PUB and different SRH. RESULTS: All blood flow detected by the DEP was arterial. Detection rates were 87.4% in major SRH-spurting @entity548 (F IA), non- @entity548 visible vessel (F IIA), clot (F IIB)-and were significantly lower at 42.3% (P  < .0001) for an intermediate group of oozing @entity548 (F IB) or flat spot (F IIC). For spurting @entity548 (F  IA) versus oozing (F IB), baseline DEP arterial flow was 100% versus 46.7%, residual blood flow detected after endoscopic hemostasis was 35.7% versus 0%, and 30-day rebleed rates were 28.6% versus 0% (all P  < .05). CONCLUSIONS: (1) For major SRH versus oozing or spot, the arterial blood flow detection rate by the DEP was significantly higher, indicating a higher rebleed risk. (2) Before and after endoscopic treatment, spurting (F IA) PUB had significantly higher rates of blood flow detection than oozing (F IB) PUB and a significantly higher 30-day rebleed rate. (3) The DEP is recommended as a new endoscopic guide with SRH to improve risk stratification and potentially definitive hemostasis for PUB.

Doppler endoscopic probe as a guide to risk stratification and definitive hemostasis of peptic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer bleeding'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage', 'bleeding', 'arterial bleeding']
@entity1066 :: (MESH:D014456,Disease) :: ['ulcer bleeding']
