Endoscopic electrocoagulation of actively bleeding arterial upper gastrointestinal lesions.

Emergency endoscopy to find the site of upper gastrointestinal bleeding is now accepted as the diagnostic method of choice. Endoscopic electrocoagulation in uncontrolled series has been successful in 98% of patients so treated (142 of 147). If a vessel is seen in an ulcer bed, some preliminary data would support surgical treatment. In my opinion, electrocoagulation is favored to prevent further bleeding. While some physicians have found electrocoagulation safe and effective, there are some who remain guardedly cautious. In the near future, a multicenter randomized study will begin to further assess the usefulness, effectiveness and safety of endoscopic electrocoagulation. Endoscopic electrocoagulation has opened a Pandora's box to exciting research in finding ways of treating acute upper gastrointestinal hemorrhage. Currently, electrocoagulation is the front runner.