Standard Endoscopic Hemostasis Versus OVESCO Severe Non-variceal UGI Hemorrhage

Inclusion Criteria: * Written informed consent from the patient or a surrogate. * Clinical evidence of severe UGIB. * Presence of a benign appearing peptic ulcer, anastomotic ulcer, or Dieulafoy's lesion, with some SRH on endoscopy. * Severe upper GI bleeding. * Life expectancy of at least 30 days based on lack of severe or terminal comorbidity as judged by the generalist or subspecialist caring for the patient. Exclusion Criteria: * Patients who are do-not-resuscitate (DNR) that is not reversible, uncooperative, refuse to participate, or are unable to give consent personally or through a legal surrogate. * Active GI malignancy, under treatment but not in remission. * Acute hypovolemic shock that is unresponsive to transfusion of 5 or more units of red blood cells (RBC's) or requires continuous intravenous vasopressor infusion for blood pressure support. * ASA (American Society of Anesthesiology) class V or higher, moribund, or with a very poor prognosis and expected survival \<30 days. * Severe coagulopathy or thrombocytopenia despite attempted reversal with transfusion of blood products (e.g persistent International Normalized Ratio \[INR\] \>2.0, platelet count \<20,000, a Partial Thromboplastin Time \[PTT\] greater than 2x upper limit of normal). * Absolute contraindication to urgent endoscopy (such as suspected perforated viscus, or peritonitis). * Stricture of the esophagus or pylorus that can not be dilated or precludes passage of a diagnostic sized endoscope and/or…