Endoscopic interventional management of bleeding duodenal and gastric ulcers.

Bleeding duodenal and gastric ulcers continue to be a common and serious problem. Definition of the precise appearance and location of the ulcer by endoscopy gives important information about the source of bleeding and additional information about the risk of rebleeding and the indications for surgery. Several endoscopic hemostatic methods are available. The nonerosive contact probes (heater and BICAP) are preferred. Injection therapy with vasoconstrictors or sclerosing agents can also be recommended as a safe, efficacious, and economical means of treatment. Several hemostatic modalities should be available for use depending on the anatomic location and type of bleeding ulcers. The collaboration of skilled interventional endoscopists with their traditional surgical colleagues offers the patient with bleeding peptic ulcer disease the optimum probability of a successful outcome, with minimum treatment-associated morbidity.