Therapy

Patients who rebleed (defined as vomiting of fresh blood, hypotension and melaena or a requirement for 4 units of blood in the 72 hours after endoscopic treatment) should be re-endoscoped ^a

Why?

• Repeat endoscopy causes fewer complications than surgery, without clearly affecting mortality ^a

Endoscopy causes fewer complications than surgery for recurrent bleeding

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
recurrent bleed from a peptic ulcer a	endoscopic haemostasis	surgery	complications at  discharge	36%	60% (12% to 82%)	5 (3 to 23)