Endoscopic hemostasis techniques for upper gastrointestinal hemorrhage: A review

Table 1 Causative diseases for upper GI-hemorrhage

Esophagus	Esophageal varices
	Esophagitis
	Mallory-weiss syndrome
	Esophageal cancer
	Others (aortointestinal fistula, foreign body, etc.)
Stomach	Ulcer (peptic ulcer, NSAID-associated ulcer, dieulafoy’s lesion, etc.)
	AGML
	Gastric varices
	Gastric cancer
	Other tumor (GIST, malignant lymphoma, etc.)
	Vascular ectasia, GAVE, PHG
	Hyperplastic polyp
	Others (foreign body, etc.)
Duodenum	Ulcer (peptic ulcer, NSAID-associated ulcer, dieulafoy’s lesion, etc.)
	Duodenitis
	Duodenal varices
	Diverticulum
	Tumor (cancer, malignant lymphoma, GIST, etc.)
	Invasion of malignant tumor (pancreas, bile duct, etc.)
	Others (hemobilia, aortointestinal fistula, etc.)

NSAIDs: Nonsteroidal anti-inflammatory drugs; AGML: Acute gastric mucosal lesion; GIST: Gastrointestinal stromal tumor; GAVE: Gastroantral vascular ectasia; PHG: Portal hypertensive gastropathy.

Table 2 Method of endoscopic hemostasis

Mechanical method	Hemoclip
	Balloon tamponade
	Ligation (EVL, detachable snare)
Injection method	Ethanol
	Epinephrine
	Monoethanolamine oleate
	Polidocanol
	N-butyl-2-cyanoacrylate
Thermo-coagulation	APC
	Heater prove
	Hemostatic forceps
	Microwaves
	Laser (Nd-YAG, diode, etc.)
Hemostyptic sprays	Thrombin
	Sodium alginate
	Fibrin glue

EVL: Endoscopic variceal ligation; APC: Argon plasma coagulation.

Table 3 Modified Forrest classification of hemorrhagic gastric ulcer

Active bleeding	Type Ia: spurting bleeding
	Type Ib: oozing bleeding
Recent bleeding	Type IIa: non-bleeding visible vessel
	Type IIb: adherent blood clot
	Type IIc: black base
No bleeding	Type III: no stigma