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Peptic ulcer haemorrhage — RACP Paediatrics MCQ

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HardGIPeptic ulcer haemorrhageRACP Paediatrics

A 10-year-old presents with melaena and haemodynamic instability. Upper GI endoscopy reveals a large duodenal ulcer with a visible vessel (Forrest classification Ia – spurting haemorrhage). What endoscopic intervention is most appropriate?

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Correct answer: B — Upper GI endoscopy

Active arterial bleeding from a peptic ulcer (Forrest Ia) requires endoscopic haemostasis. Endoscopic techniques include injection (adrenaline), thermal coagulation (heater probe, APC), and mechanical (clips). Dual therapy (injection plus thermal or mechanical) is recommended for high-risk lesions. IV PPI infusion should continue post-procedure. Helicobacter pylori testing and eradication is essential.

Reference: RCH Melbourne – 2023 – GI Bleeding CPG; RACP Paediatric Curriculum – GI