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Despite its observed benefits in selected patients, current guidelines do not recommend routine use of second-look endoscopy after endoscopic hemostasis. Investigators in Taiwan prospectively studied 316 patients with peptic ulcer bleeding requiring hemostasis to identify characteristics of patients most likely to benefit from second-look endoscopy.
All patients were treated with a proton-pump inhibitor (PPI) infusion. Second-look endoscopy was performed on the third day after hemostasis in 228 patients and on the second day in 78 patients. Results were as follows:
More patients were identified with endoscopic stigmata for recurrent hemorrhage (SRH) in second-look endoscopy on day two versus day three after hemostasis (15% vs. 5%; P=0.002).
In…