{{Short description|Classification of upper gastrointestinal hemorrhage}} '''Forrest classification''' is a classification of upper gastrointestinal hemorrhage used for purposes of comparison and in selecting patients for endoscopic treatment.<ref>{{Cite book|url = https://books.google.com/books?id=e0FDyiGTwM8C|title = Endoscopy of the Upper GI Tract: A Training Manual|last = Block|first = Berthold|last2 = Schachschal|first2 = Guido|last3 = Schmidt|first3 = Hartmut H.|date = 2004-01-01|publisher = Thieme|isbn = 9783131367310|language = en}}</ref>
==Forrest classification== [[File:DU 2.jpg|right|thumb|Endoscopy image of a duodenal ulcer in the posterior part of the duodenal bulb without stigmata of recent hemorrhage. This would be a '''Forrest III''' lesion]]
'''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 (coffee ground base) on ulcer base)
'''Lesions without active bleeding''' * Forrest III (Lesions without signs of recent hemorrhage or fibrin-covered clean ulcer base)<ref>{{Cite web|url = http://www.endoskopischer-atlas.de/m06ae.htm|title = Stomach: Forrest classification in Atlas of Gastroenterological Endoscopy by A. Freytag, T. Deist|last = T. Deist|first = A. Freytag|website = www.endoskopischer-atlas.de|access-date = 2016-04-11}}</ref>
==Application==
Forrest's 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.<ref name="hadzibulic">{{cite web|url=http://publisher.medfak.ni.ac.rs/2007-html/4-broj/SIGNIFICANCE%20OF%20FORREST...pdf |title=SIGNIFICANCE OF FORREST CLASSIFICATION, ROCKALL’S AND BLATCHFORD’S RISK SCORING SYSTEM IN PREDICTION OF REBLEEDING IN PEPTIC ULCER DISEASE |last=Hadzibulic |first=Edvin |author2=Svjetlana Govedarica |accessdate=2008-08-11 |url-status=dead |archiveurl=https://web.archive.org/web/20130603031133/http://publisher.medfak.ni.ac.rs/2007-html/4-broj/SIGNIFICANCE%20OF%20FORREST...pdf |archivedate=June 3, 2013 }}</ref> A prospective controlled study revealed that "Forrest criteria are essential for proper planning of endoscopic therapy and urgent surgery in bleeding peptic ulcers".<ref name="heldwein">{{cite journal|doi=10.1055/s-2007-1010729|author=Heldwein W|author2=Schreiner J |author3=Pedrazzoli J |author4=Lehnert P |date=Nov 21, 1989|title=Is the Forrest classification a useful tool for planning endoscopic therapy of bleeding peptic ulcers?|journal=Endoscopy|volume=21|pages=258–62| issue=6|pmid=2693077}}</ref>
== History == The classification was first published by J.A. Forrest, ''et al.'' in the Lancet in 1974.<ref>{{Cite journal | last1 = Forrest | first1 = JA. | last2 = Finlayson | first2 = ND. | last3 = Shearman | first3 = DJ. | title = Endoscopy in gastrointestinal bleeding. | journal = Lancet | volume = 2 | issue = 7877 | pages = 394–7 |date=Aug 1974 | doi = 10.1016/s0140-6736(74)91770-x| pmid = 4136718 }}</ref>
==See also== * Rockall score * Glasgow-Blatchford
==References==
{{reflist}}
==External links== * [http://www.msgh.org.my/resources/forrest.htm Illustrated Forrest classification] {{Webarchive|url=https://web.archive.org/web/20200221111142/http://www.msgh.org.my/resources/forrest.htm |date=2020-02-21 }} * [https://www.clevelandclinicmeded.com/medicalpubs/pharmacy/septoct2003/table1.htm Forrest Classification System with Respective Prognosis]
Category:Diagnostic gastroenterology Category:Medical scales