Severe upper GI (UGI) bleeding is a relatively frequent reason for hospital admission in adult patients (1). In most major medical centers, peptic ulcers are still the most common etiology for UGI hemorrhage (2, 3). However, in North America and some European countries, ulcers are becoming less prevalent as the cause of UGI hemorrhage than varices, tumors, Mallory Weiss tears, and angiomas. This may relate to primary prophylaxis (such as eradication of Helicobacter pylori) or secondary prophylaxis in high-risk patients such as those with a prior history of ulcer hemorrhage or those taking nonsteroidal anti-inflammatory drugs or aspirin (4).