James Y.W. Lau, MD, FRCS; Joseph J.Y. Sung, MD, PhD, FRCP, FRACP
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Lau J., Sung J.; Management Options for Patients with Ulcer Hemorrhage. Ann Intern Med. 2004;140:845-846. doi: 10.7326/0003-4819-140-10-200405180-00029
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Published: Ann Intern Med. 2004;140(10):845-846.
TO THE EDITOR:
Dr. Jensen (1) concurred with the conclusion of our randomized study (2) that intravenous proton-pump inhibitor (PPI) infusion as an adjunct to endoscopic therapy was superior to infusion alone for treating ulcers with nonbleeding visible vessels and adherent clots. He also commented that the rate of recurrent bleeding among patients who received intravenous PPI infusion alone was somewhat lower than the rates reported in series that were conducted in the era of H2-receptor antagonists and that used variable techniques and vigor for treating these ulcers (3). Many other factors, such as the size and depth of these ulcers and their proximity to larger arteries, probably contribute to the rate of recurrent bleeding. Without a control group for comparison, the true benefit of intravenous PPI infusion alone is unknown. Like us, Dr. Jensen cautioned against the use of intravenous PPI alone for treating ulcers with nonbleeding visible vessels and adherent clots.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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