[Acute ulcer hemorrhage and current endoscopic hemostatic procedures]

The introduction of diagnostic and therapeutic endoscopy resulted in a drastic decrease in the mortality rates of acutely bleeding ulcer. In addition to thermal coagulation procedures (electrocoagulation, laser, heater probe), injection techniques (adrenaline, ethanol, polidocanol, fibrin adhesive) are available. A combination of initial injection of adrenaline followed by thermocoagulation, or injection of polidocanol, has proved most effective. In the case of fibrin adhesive, applied by non-traumatic means, controlled studies have yet to be performed. The question as to whether, after endoscopic hemostasis, early elective surgery can be obviated in numerous cases, needs to be investigated by controlled prospective studies.