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Forrest classification is a classification of upper gastrointestinal hemorrhage used for purposes of comparison and in selecting patients for
Acute hemorrhage
* Forrest I a (Spurting hemorrhage)
* Forrest I b (Oozing hemorrhage)
Signs of recent hemorrhage
* Forrest II a (Non bleeding Visible vessel)
* Forrest II b (Adherent clot)
* Forrest II c (Flat pigmented
Illustrated Forrest classification
Diagnostic gastroenterology
endoscopic treatment
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
.
Forrest classification
Acute hemorrhage
* Forrest I a (Spurting hemorrhage)
* Forrest I b (Oozing hemorrhage)
Signs of recent hemorrhage
* Forrest II a (Non bleeding Visible vessel)
* Forrest II b (Adherent clot)
* Forrest II c (Flat pigmented haematin
Haematin (also known as hematin, ferriheme, hematosin, hydroxyhemin, oxyheme, phenodin, or oxyhemochromogen) is a dark bluish or brownish pigment containing iron in the ferric state, obtained by the oxidation of haem.
Haematin inhibits the synt ...
(coffee ground base) on ulcer base)
Lesions without active bleeding
* Forrest III (Lesions without signs of recent hemorrhage or fibrin-covered clean ulcer base)
Application
Forrest classification is instrumental when stratifying patients with upper gastrointestinal hemorrhage into high and low risk categories formortality
Mortality is the state of being mortal, or susceptible to death; the opposite of immortality.
Mortality may also refer to:
* Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
. It is also a significant method of prediction of the risk of rebleeding and very often is used for evaluation of the
endoscopic intervention modalities. A prospective controlled study revealed that "Forrest criteria are essential for proper planning of endoscopic therapy and urgent surgery in bleeding peptic ulcers".
History
The classification was first published by J.A. Forrest ''et al.'' in the Lancet in 1974.See also
*Rockall score
Rockall risk scoring system attempts to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding. Rockall ''et al.'' identified independent risk factors in 1996 which were later shown to predict mortality accura ...
* Glasgow-Blatchford
The Glasgow-Blatchford bleeding score (GBS) is a screening tool to assess the likelihood that a person with an acute upper gastrointestinal bleeding (UGIB) will need to have medical intervention such as a blood transfusion or endoscopic interventi ...
References
{{reflistExternal links
Illustrated Forrest classification
Diagnostic gastroenterology