ToolsCalculators
Forrest classification of upper GI bleeding
Endoscopic stigmata and rebleeding risk in peptic ulcer bleeding.
Forrest classification of upper GI bleeding
Endoscopic finding
ResultForrest III - clean base
Low-risk stigmata: endoscopic therapy is generally not required.
- Untreated rebleeding risk
- ~5 %
When to use
- Describing endoscopic stigmata of a bleeding peptic ulcer to guide haemostatic therapy and disposition.
Formula
Class I active bleeding (Ia spurting, Ib oozing); Class II recent bleeding (IIa visible vessel, IIb adherent clot, IIc flat spot); Class III clean base. Rebleeding risk falls from ~55% (Ia/Ib) to ~5% (III).
Pearls and pitfalls
- Forrest Ia-IIa lesions warrant endoscopic haemostasis; IIc and III can usually be managed without endoscopic therapy.