Rokcall score versus forrest classification in endoscopic management of bleeding peptic ulcer

Abstract

Acute upper gastrointestinal bleeding (UGIB) remains an important emergency situation. In the last two decades, major developments took place influencing incidence, etiology and outcome of patients with acute UGIB. Peptic ulcer bleeding is the most significant complication of ulcer disease being responsible for 50% of all cases mortality. Aim of the study: To compare between endoscopic clip application versus argon plasma coagulation in management of bleeding peptic ulcer (BPU). Patients and Methods: Sixty patients suffering from acute UGIB were randomly divided into two groups: group I included 30 patients treated with endoscopic clip application and Group II included 30 patients subjected to endoscopic APC. All patients were classified according to Forrest classification and the clinical Rockall score. Results: There were significant differences between the two groups as regard Forrest classification (P < 0.05) there were insignificant difference between the two groups as regard rockall score, site of the ulcer and re bleeding (P > 0.05). Re bleeding was significant with higher Rockall score in group I (P < 0.05) but it was insignificant in group II (P > 0.05). Conclusion: Endoscopic application of hemoclips have a less re bleeding rate than Argon plasma coagulation for treatment of bleeding peptic ulcer, although this was statistically insignificant, meanwhile APC is still less cost and easy. Clinical and endoscopic assessment (through Rokcall score and Forrest classification) could help in making best choice for endoscopic management.