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Contact thermal devices for the treatment of bleeding peptic ulcers

John R Saltzman, MD, FACP, FACG, FASGE, AGAF
Section Editor
Douglas A Howell, MD, FASGE, FACG
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF


The treatment of bleeding peptic ulcers includes resuscitation, treatment with acid suppressive therapy, and application of endoscopic therapy for patients at high risk of ongoing or recurrent bleeding (table 1). Several endoscopic approaches can be used to treat bleeding peptic ulcers, including use of contact thermal devices, endoscopic hemoclips, and epinephrine injection.

This topic will review the use of contact thermal devices for the treatment of bleeding peptic ulcers. An overview of the treatment of bleeding peptic ulcers, issues to consider when deciding which specific endoscopic therapies to use, and treating bleeding ulcers with endoscopic hemoclips, epinephrine injection, or argon plasma coagulation are discussed elsewhere. (See "Approach to acute upper gastrointestinal bleeding in adults" and "Overview of the treatment of bleeding peptic ulcers" and "Endoclip therapy in the gastrointestinal tract: Bleeding lesions and beyond", section on 'Bleeding peptic ulcers' and "Argon plasma coagulation in the management of gastrointestinal hemorrhage".)


Contact thermal therapy is one option for treating ulcers with stigmata of recent hemorrhage (table 2) [1]. It can also be used to treat patients with bleeding from Dieulafoy's lesions, Mallory-Weiss tears, and gastric antral vascular ectasias. (See "Overview of the treatment of bleeding peptic ulcers", section on 'Endoscopic therapy' and "Causes of upper gastrointestinal bleeding in adults", section on 'Specific causes'.)

The appearance of ulcers can be described using the Forrest classification [2]:

Class Ia – Spurting hemorrhage (picture 1 and movie 1)

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Literature review current through: Nov 2017. | This topic last updated: Jan 13, 2016.
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