Endoscopic assessment of blood flow in duodenal ulcers

F. W. Leung, D. N W Wong, J. Lau, E. M. Bondoc, R. Hsu, Joseph Leung

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


The importance of blood flow in duodenal ulcer healing is unclear. Endoscopic reflectance spectrophotometry measures the index of oxygen saturation (ISO2), which is significantly correlated with blood flow. In 97 consecutive patients who presented with duodenal ulcer bleeding, the difference in the index of oxygen saturation (δISO2: ulcer margin ISO2 minus adjacent mucosa ISO2) was determined during the initial endoscopic examination. Endoscopic examinations were repeated until the ulcers had healed (n = 86). Relative to the adjacent mucosa, 78% of the ulcer margins had increased blood flow (positive δISO2) and 22% had decreased blood flow (negative δISO2). Stepwise multi-linear regression analysis selected δISO2, ulcer size, and stigmata of recent hemorrhage as predictors of delayed healing. A significant negative linear correlation between δISO2 and ulcer healing time (r = -0.35, p < 0.001, n = 86) was demonstrated. The scatter in the data precludes prediction of ulcer healing based on δISO2 measurement in an individual patient. Multi-variate logistic regression analysis selected concurrent medical illness, duodenal deformity, frequent use of non-steroidal anti-inflammatory drugs, and stigmata of recent hemorrhage as factors significantly associated with delayed (longer than 5 weeks) ulcer healing. The results support the hypothesis that prognostic factors are identifiable at the time of ulcer diagnosis, even in patients who present with bleeding. Blood flow remains an equivocal factor that deserves to be re-studied taking multiple measurements around the ulcer and including a larger number of slow healers.

Original languageEnglish (US)
Pages (from-to)334-341
Number of pages8
JournalGastrointestinal Endoscopy
Issue number3
StatePublished - 1994
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology


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