{"id":5447,"date":"2015-03-27T23:31:04","date_gmt":"2015-03-27T23:31:04","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/classificacao\/publish\/"},"modified":"2025-09-05T09:05:33","modified_gmt":"2025-09-05T09:05:33","slug":"classificacoes-forrest","status":"publish","type":"classificacao","link":"https:\/\/endoscopiaterapeutica.net\/pt\/classificacao\/classificacoes-forrest\/","title":{"rendered":"Classifica\u00e7\u00e3o de Forrest"},"content":{"rendered":"\n

Objetivo<\/h2>\n\n\n\n

A Classifica\u00e7\u00e3o Forrest, descrita inicialmente por J.A. Forrest et al. em 1974 no The Lancet, \u00e9 um sistema de classifica\u00e7\u00e3o amplamente utilizado para sangramento gastrointestinal alto relacionado a \u00falceras. O objetivo principal desta classifica\u00e7\u00e3o \u00e9 facilitar a comunica\u00e7\u00e3o efetiva entre endoscopistas, fornecendo uma descri\u00e7\u00e3o padronizada do sangramento de \u00falceras. Com o tempo, tamb\u00e9m se tornou uma ferramenta valiosa para prever o risco de sangramento, ressangramento e mortalidade em pacientes.<\/p>\n\n\n\n

Crit\u00e9rios<\/h2>\n\n\n\n

O sistema de classifica\u00e7\u00e3o categoriza \u00falceras sangrantes em diferentes tipos com base nos achados endosc\u00f3picos. Essas categorias ajudam a avaliar a gravidade e prever o curso cl\u00ednico do sangramento. A classifica\u00e7\u00e3o inclui as seguintes categorias:<\/p>\n\n\n

\"\"<\/p>\n

\n\n\n\n\n\n\n\n\n\n
Sangramento<\/th>\nClassifica\u00e7\u00e3o de Forrest<\/th>\nApar\u00eancia Endosc\u00f3pica<\/th>\nTaxa de Re-sangramento<\/th>\nRecomenda\u00e7\u00e3o de Tratamento endosc\u00f3pico<\/th>\n<\/tr>\n<\/thead>\n
Ativo<\/td>\nIA<\/td>\nSangramento em “jato”<\/td>\n90%<\/td>\nTratar<\/td>\n<\/tr>\n
Ativo<\/td>\nIB<\/td>\nSangramento em “baba\u00e7\u00e3o”<\/td>\n10-20%<\/td>\nTratar<\/td>\n<\/tr>\n
Recente<\/td>\nIIA<\/td>\nVaso vis\u00edvel sem sangramento ativo<\/td>\n50%<\/td>\nTratar<\/td>\n<\/tr>\n
Recente<\/td>\nIIB<\/td>\nCo\u00e1gulo aderido<\/td>\n25-30%<\/td>\nConsiderar tratamento<\/td>\n<\/tr>\n
Recente<\/td>\nIIC<\/td>\nBase de \u00falcera com res\u00edduo de hematina<\/td>\n7-10%<\/td>\nN\u00e3o tratar<\/td>\n<\/tr>\n
Sem sangramento<\/td>\nIII<\/td>\n\u00dalcera de base limpa<\/td>\n3-5%<\/td>\nN\u00e3o tratar<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\n\n

<\/h2>\n\n\n\n

Aplica\u00e7\u00e3o Cl\u00ednica <\/h2>\n\n\n\n
    \n
  • Alto risco (Forrest Ia – IIb): indica\u00e7\u00e3o de terapia endosc\u00f3pica imediata (inje\u00e7\u00e3o, coagula\u00e7\u00e3o t\u00e9rmica ou clipagem), al\u00e9m de IBP em alta dose. <\/li>\n\n\n\n
  • Baixo risco (Forrest IIc\/III): manejo conservador com IBP e dieta; alta precoce pode ser considerada. <\/li>\n\n\n\n
  • \u00c9 amplamente utilizada em guidelines internacionais (ASGE, ESGE, ACG) para orientar conduta em hemorragia digestiva alta.<\/li>\n<\/ul>\n\n\n\n

    Refer\u00eancia:<\/h2>\n\n\n\n

    Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974 Aug 17;2(7877):394-7. doi: 10.1016\/s0140-6736(74)91770-x. PMID: 4136718.<\/p>\n","protected":false},"excerpt":{"rendered":"

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