{"id":3960,"date":"2023-01-30T10:00:00","date_gmt":"2023-01-30T09:00:00","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=klassifikationen&p=3960"},"modified":"2025-09-23T14:55:42","modified_gmt":"2025-09-23T12:55:42","slug":"forrest-classification","status":"publish","type":"klassifikationen","link":"https:\/\/www.endoscopy-campus.com\/en\/classifications\/forrest-classification\/","title":{"rendered":"Forrest Classification"},"content":{"rendered":"\n

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nThe Forrest Classification was first described in 1974 by\nJ.A. Forrest et al.<\/em> in The<\/em>Lancet1<\/sup><\/em>. This classification\nis a widely used classification of ulcer-related upper gastrointestinal\nbleeding. It was initially developed to unify the description of ulcer bleeding\nfor better communication amongst endoscopists. However, the Forrest Classification\nis now used as a tool to identify patients who are at an increased risk for\nbleeding, rebleeding and mortality2\u20134<\/sup>. \n\n\n\n<\/p>\n\n\n\n

Forrest Classification<\/td><\/td><\/tr>
Acute haemorrhage
<\/strong> Forrest Ia
Forrest Ib<\/td>
Active spurter
Active oozing<\/td><\/tr>
Signs of recent haemorrhage<\/strong>
Forrest IIa
Forrest IIb
Forrest IIc<\/td>
Non-bleeding visible vessel
Adherent clot
Flat pigmented haematin on ulcer base<\/td><\/tr>
Lesions without active bleeding<\/strong>
Forrest III<\/td>
Clean-based ulcer<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
<\/div>\n\n\n\n
<\/div>\n\n\n\n

Example illustrations<\/h3>\n\n\n\n
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Figure 1. Forrest Ia gastric ulcer with an active spurter<\/figcaption><\/figure>\n<\/div>\n\n\n
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Figure 2a. Forrest Ib ulcer with active oozing<\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n
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Figure 2b. Forrest Ib ulcer with active oozing<\/figcaption><\/figure>\n<\/div>\n\n\n

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Figure 2c (i). Forrest Ib ulcer at the gastrojejunal anastomosis, with visible vessel and active oozing. <\/figcaption><\/figure>\n<\/div>\n\n\n

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Figure 2c (ii). The same ulcer as above, but after an injection of adrenaline. This shows a visible vessel at the anastomotic ulcer.<\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n
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Figure 3a. Forrest IIa ulcer with a visible vessel<\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n
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Figure 3b(i). Forrest IIb ulcer at incisura. With ulcers with an adherent clot, it is important that the clot must be removed by vigorous and meticulous flushing in order to reveal underlying visible vessels.<\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n
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Figure 3b(ii). The same ulcer as above, but after the clot was removed. It revealed an underlying visible vessel.<\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n
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Figure 4a. Forrest IIb ulcer with an adherent clot<\/figcaption><\/figure>\n<\/div>\n\n\n

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Figure 4b. Forrest IIb ulcer with an adherent clot <\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n
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Figure 5. Forrest IIc ulcer with a pigmented spot<\/figcaption><\/figure>\n<\/div>\n\n\n

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Figure 6a. Forrest III ulcer at antrum with clean base<\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n
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Figure 6b. Forrest III ulcer at anterior wall of D1\/2 with clean base<\/figcaption><\/figure>\n<\/div>\n\n\n

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<\/div>\n<\/div>\n\n\n\n

References:<\/h3>\n\n\n\n
    \n
  1. Forrest, JA.; Finlayson, ND.; Shearman, DJ. (Aug 1974). \u2018Endoscopy in gastrointestinal bleeding\u2019. Lancet<\/em>. 2<\/strong> (7877): 394\u20137. <\/li>\n\n\n\n
  2. Rockall, TA, Logan, RF, Devlin, HB et al. \u2018Risk assessment after acute upper gastrointestinal haemorrhage\u2019. Gut<\/em> 1996; 38: 316\u201321.<\/li>\n\n\n\n
  3. Guglielmi A, Ruzzenente, A, Sandri, M et al. \u2018Risk assessment and prediction of rebleeding in bleeding gastroduodenal ulcer\u2019. Endoscopy<\/em> 2002; 34: 778\u201386.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    The Forrest Classification is now used as a tool to identify patients who are at an increased risk for bleeding, rebleeding and mortality<\/p>\n","protected":false},"featured_media":3962,"template":"","categories":[94,93],"tags":[1005,1398,1396,1395,1394,1393,1390,1397],"ec-magazin-ausgaben":[3597],"sponsoren-erwaehnung":[],"autor":[4046],"class_list":["post-3960","klassifikationen","type-klassifikationen","status-publish","has-post-thumbnail","hentry","category-classifications","category-upper-gi-tract","tag-bleeding","tag-clot","tag-haematin","tag-haemorrhage","tag-hemorrhage","tag-rebleeding","tag-upper-gi","tag-vessel","ec-magazin-ausgaben-ec-magazine-2023-01","autor-shannon-melissa-chan"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/klassifikationen\/3960","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/klassifikationen"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/klassifikationen"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media\/3962"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=3960"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=3960"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=3960"},{"taxonomy":"ec-magazin-ausgaben","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-magazin-ausgaben?post=3960"},{"taxonomy":"sponsoren-erwaehnung","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/sponsoren-erwaehnung?post=3960"},{"taxonomy":"autor","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/autor?post=3960"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}