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{{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|[[Esophagogastroduodenoscopy|Endoscopy]] image of a [[duodenal ulcer]] in the posterior part of the [[duodenum|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 [[peptic ulcer|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 rate|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 (journal)|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 }}
* [http://www.clevelandclinicmeded.com/medicalpubs/pharmacy/septoct2003/table1.htm Forrest Classification System with Respective Prognosis]

[[Category:Diagnostic gastroenterology]]
[[Category:Medical scales]]

Forrest classification - Revision history

imported>Mild Bill Hiccup: /* top */ Spelling/grammar/punctuation/typographical correction