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Acute gastrointestinal (GI) bleeding is common in both the outpatient setting and the emergency department. Annual U.S. incidence rates over the past decade are approximately 90–108 per 100 000 persons (1), leading to approximately 300 000 hospitalizations annually. Most cases are due to nonvariceal sources of bleeding (e.g., peptic ulcers) and continue to be associated with significant mortality (3–14%) and health economic burden (1–3). The incidence of nonvariceal bleeding may be decreasing in the West largely because of decreased incidence of Helicobacter pylori infection and increased awareness and implementation of ulcer-prevention strategies in users of nonsteroidal anti-inflammatory drugs (NSAIDs) (1). However, identifying patients with acute GI bleeding who are in danger of serious adverse events and establishing evidence-based treatment plans are essential in both primary and specialty care.
Duodenal ulcer with a non-bleeding visible arterial vessel before (Panel A) and following (Panel B) endoscopically applied bipolar electrocoagulation to coapt the arterial walls, reducing the risk for further bleeding-related complications.
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