Forrest Classification
Classifies endoscopic findings of bleeding peptic ulcer and rebleeding risk.
When to use
Endoscopy in adults with bleeding peptic ulcer, to describe the finding and rebleeding risk.
Pearls and pitfalls
- Ia and Ib indicate active bleeding; IIa and IIb indicate stigmata of recent bleeding.
- IIc and III have lower rebleeding risk.
- The classification depends on field visibility and endoscopist experience.
- The hemostasis and discharge decision considers comorbidities, anticoagulants and stability.
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Formula
Choose the class matching the endoscopic finding, from Ia to III.
Evidence
Endoscopic classification proposed to relate ulcer appearance to recurrent bleeding risk.
References
- Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974;2(7877):394-397. doi:10.1016/s0140-6736(74)91770-x
Frequently asked questions
What is Forrest Classification?
Classifies endoscopic findings of bleeding peptic ulcer and rebleeding risk. Endoscopy in adults with bleeding peptic ulcer, to describe the finding and rebleeding risk.
How is the result calculated?
Choose the class matching the endoscopic finding, from Ia to III.
How should the result be interpreted?
Endoscopic classification proposed to relate ulcer appearance to recurrent bleeding risk.
What are the sources?
Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974;2(7877):394-397.