Prophylactic injection therapy is necessary for Forrest type 2b duodenal ulcers.

Objective: To assess the effect of prophylactic injection therapy during the index
gastroscopy on upper gastrointestinal bleeding due to Forrest type 2b duodenal ulcer.
Methods: The patients who were admitted with upper gastrointestinal bleeding and
who had emergency gastroscopy between January 2004 and January 2011 were
retrospectively recruited to the study. Among those, the patients with Forrest type 2b
duodenal ulcer were selected and divided into two groups. The patients in Group 1 had
only diagnostic gastroscopy, whereas those in Group 2 had prophylactic injection therapy
during the index gastroscopy.
Results: Eighty seven patients were included to the study. There were 41 patients in
Group 1 and 46 patients in Group 2. There was a significant difference in the incidence
of rebleeding (26.8% versus 6.5%, p=0.017). The mortality rate was similar in both
groups (9.7% versus 2.1%, p=0.184).
Conclusion: We recommend prophylactic injection therapy in patients with upper
gastrointestinal bleeding who have Forrest type 2b duodenal ulcer.