MODERN ENDOSCOPIC TREATMENT OF UPPER GIT BLEEDING
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Key words: endoscopic hemostatic techniques, variceal bleeding, rebleeding, sclerosant risks##article.abstract##
Abstract: Upper gastrointestinal GI bleeding remains a medical emergency with mortality rates of 5 to 10% despite advances in therapy [1]. This review synthesizes current evidence on endoscopic management, analyzing 37 clinical studies and 11 meta analyses published between 2024-2025. We evaluate the efficacy of established techniques (injection, thermal and mechanical) alongside emerging therapies like hemostatic powders focusing on comparative outcomes from randomized controlled trials.
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