Upper GI bleed - Mosche schein + WSES

Question 1

Bleeding peptic ulcer (WSES)
Diagnosis
In patients with suspected bleeding peptic ulcer,
which biochemical and imaging investigations should
be requested?

In patients with bleeding peptic ulcer, are the
endoscopic findings useful to determine the risk for
rebleeding and how do they affect the clinical
management?

In patients with bleeding peptic ulcer, which parameters
should be evaluated at ED referral and which criteria
should be adopted to define an unstable
patient?

Question 2

Rockall ?
Glasgow Blatchford bleeding score ?

Answer 2

Question 3

In patients with bleeding peptic ulcer, which are
the appropriate targets for resuscitation (hemoglobin
level, blood pressure/heart rate, lactates level,
others)?

Question 4

Non-operative management—endoscopic treatment
In patients with bleeding peptic ulcer, which are the
indications for non-operative management?

Question 5

Surgery
In patients with bleeding peptic ulcer, which are the
indications for surgical treatment and which is the
appropriate timing for surgery?
In patients with bleeding peptic ulcer, we suggest surgical
hemostasis (or angiographic embolization if immediately
available and with appropriate skills) after failure
of repeated endoscopy. In patients with hypotension and/
or hemodynamic instability and/or ulcer larger than 2
cm at first endoscopy, we suggest surgical intervention
without repeated endoscopy (strong recommendation
based on very low-quality evidences, 1D).
A renowned RCT conduct

Question 6

Mosche :
What is the etiology of bleeding in need of your surgical
attention?