Bleeding peptic ulcer remains the commonest cause of emergency hospital admission worldwide and carries a mortality of up to 10%. Ulcer rebleeding is one of the important risk factors for mortality, and numerous strategies were examined to prevent ulcer rebleeding including the performance of scheduled second endoscopy and adjunctive proton pump inhibitor infusion. This article reviews the current management of bleeding peptic ulcer, including the prediction of clinical outcomes for bleeding peptic ulcer; the use of second-look endoscopy and adjunctive proton pump inhibitor infusion for prevention of rebleeding; and potential future development in achieving better primary endoscopic hemostasis with the use of endoscopic suturing.
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