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Artif Intell Gastrointest Endosc. Dec 8, 2023; 4(2): 12-17
Published online Dec 8, 2023. doi: 10.37126/aige.v4.i2.12
Role of endoscopic ultrasound in non-variceal upper gastrointestinal bleeding management
Cosmas Rinaldi Adithya Lesmana
Cosmas Rinaldi Adithya Lesmana, Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta 10430, DKI, Indonesia
Cosmas Rinaldi Adithya Lesmana, Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta 12950, Indonesia
Cosmas Rinaldi Adithya Lesmana, Gastrointestinal Cancer Center, MRCCC Siloam Semanggi Hospital, Jakarta 12930, Indonesia
Author contributions: Lesmana CRA conceptualized the review, and wrote and edited the manuscript.
Conflict-of-interest statement: Cosmas Rinaldi Adithya Lesmana has no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cosmas Rinaldi Adithya Lesmana, FACG, FACP, MD, PhD, Associate Professor, Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, JL. Diponegoro 71, Jakarta 10430, DKI, Indonesia. medicaldr2001id@yahoo.com
Received: July 28, 2023
Peer-review started: July 28, 2023
First decision: September 29, 2023
Revised: October 14, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: December 8, 2023
Processing time: 131 Days and 10.7 Hours
Abstract

Non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the challenging situations in clinical practice. Despite that gastric ulcer and duodenal ulcer are still the main causes of acute NVUGIB, there are other causes of bleeding which might not always be detected through the standard endoscopic evaluation. Standard endoscopic management of UGIB consists of injection, thermal coagulation, hemoclips, and combination therapy. However, these methods are not always successful for rebleeding prevention. Endoscopic ultrasound (EUS) has been used recently for portal hypertension management, especially in managing acute variceal bleeding. EUS has been considered a better tool to visualize the bleeding vessel in gastroesophageal variceal bleeding. There have been studies looking at the role of EUS for managing NVUGIB; however, most of them are case reports. Therefore, it is important to review back to see the evolution and innovation of endoscopic treatment for NVUGIB and the role of EUS for possibility to replace the standard endoscopic haemostasis management in daily practice.

Keywords: Non-variceal upper gastrointestinal bleeding; Endoscopic haemostasis; Endoscopic ultrasound; Bleeding vessel; Doppler image

Core Tip: Non-variceal upper gastrointestinal bleeding is still one of the challenging situations in clinical practice. Standard endoscopic hemostasis has shown to have a high successful bleeding control rate; however, in some types of bleeding, there is still a possibility for endoscopic treatment failure. Endoscopic ultrasound can give a better bleeding vessel visualization, and it has shown to be a promising tool for non-variceal upper gastrointestinal bleeding management.