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Lau JYW et al. - Managing massive bleeding from a peptic ulcer remains a challenge, and it should involve a multidisciplinary team. Endoscopy is the first-line treatment. Even with larger ulcers, endoscopic hemostasis can be achieved in the majority of cases. Surgery is clearly indicated in patients in whom arterial bleeding cannot be controlled at endoscopy. Angiographic embolization is an alternate option, particularly in those unfit for surgery.

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