[Endoscopic therapy of acute upper gastrointestinal bleeding. A breakthrough in non-variceal bleeding?]

Endoscopic therapy adds a new tool to the management of acute upper gastrointestinal hemorrhage. Endoscopic sclerotherapy being now a well established therapy for acute variceal bleeding, a simple and effective therapy for nonvariceal bleeding was missing. Recently coagulation therapy with laser, electric current or thermocouples has come into use, but injection therapy with hemostatic and sclerosing agents seems a simple, costeffective and relatively safe method. In uncontrolled trials the overall success rate in achieving hemostasis was over 90% and the need for emergency surgery was dramatically reduced. Injection therapy appears to be a major advance in the treatment of nonvariceal bleeding, especially in high risk patients.