Endoscopic Management of Acute Non Variceal Upper Gastrointestinal Bleeding

Acute upper gastrointestinal bleeding (UGIB) is a common cause of hospitalization, with incidences ranging from 48 to 160 cases per 100,000 adults per year. The management of acute non-variceal UGIB includes the performance of an early endoscopy within 24 hours, and the treatment of high-risk lesions using various endoscopic mono- or combination therapies (all favored over epinephrine injection alone). Beyond the endoscopic approach, adequate resuscitation and risk stratification before endoscopy are important in optimizing the care of patients with UGIB. A repeat endoscopy is warranted in rebleeding, whereas “second-look” endoscopy should not be performed routinely, but only in selected patients. Key elements are reviewed along with the current evidence with a focus on the endoscopic approach and therapy of non-variceal UGIB.