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Forrest classification is a classification of
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
upper gastrointestinal hemorrhage
Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit or in altered form as black stool. De ...
used for purposes of comparison and in selecting patients for endoscopic treatment.
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 synth ...
(coffee ground base) on ulcer
An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
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 for mortality. 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 prospectivecontrolled study
A scientific control is an experiment or observation designed to minimize the effects of variables other than the independent variable (i.e. confounding variables). This increases the reliability of the results, often through a comparison be ...
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 * Glasgow-BlatchfordReferences
{{reflistExternal links
Illustrated Forrest classification
Diagnostic gastroenterology