Appendix F

 Algorithm of diagnosis and treatment

of bleeding ulcer



Weakness, haematomesis, melena



Emergency endoscopy



Forrest I                          Forrest II                               Forrest III



                       Endoscopic haemostasis + conservative therapy




Evaluation of effect using clinical and endoscopic control




Forrest I                          Forrest II                          Forrest III



Absolute                       Relative                           Prolongation

indication                    indication                         of conservative                     for surgery                  for surgery                              therapy     




   Removal of all ulcer substrates is