Ulcers with stigmata of recent hemorrhage (SRH) but without evidence of active bleeding (Forrest 11 bleeding) are a common endoscopic finding in patients with upper gastrointestinal bleeding. This study considers the problem of identifying patients in this group at risk of further bleeding and death. The high incidence of rebleeding in patients with visible vessel and the low incidence in patients with other SRH or no SRH suggest that endoscopic therapy in the absence of active bleeding is best limited to patients with visible vessels in ulcers that have recently bled. Evidence from controlled trials of laser therapy is presented which suggests that laser therapy can reduce the incidence of rebleeding in such patients with visible vessel.
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