What is the management of nonvariceal UGI bleeding that is refractory to initial endoscopic management?
- Initial endoscopic therapy is successful in obtaining permanent control of bleeding in 80% to 90% of patients with nonvariceal UGI bleeding.
- In patients with recurrent bleeding after endoscopic therapy, approximately 70% will be controlled after a second attempt at endoscopic therapy.
- Angiography or surgery is recommended in patients who continue to bleed despite two attempts at endoscopic hemostasis.
- Surgical or radiographic consultation should be obtained in patients who present with massive bleeding.
