A 40-year-old man presented to the hospital with an upper gastrointestinal bleed. Upper endoscopy revealed a visible vessel in an ulcer base, which was treated with epinephrine and thermal coagulation. You start him on a proton pump inhibitor.

The risk of recurrent upper gastrointestinal bleeding from a peptic ulcer is highest in cases with active arterial bleeding followed by a visible vessel. The risk is lowest with a clean base ulcer, where patients can be discharged following endoscopy. After hemostasis is achieved in high-risk lesions, patients should be observed and receive continuous infusion of PPI for 72 hours.

Gastrointestinal Disorders

Some patients with upper GI bleeding can be sent home after endoscopy; others require extended treatment and inpatient observation.

Upper GI Bleed With Visible Vessel: How Long to Observe After Treatment?