Abstract
There are over half a million patients hospitalized annually for gastrointestinal hemorrhage (GIH) in the USA [1]. The overall inpatient mortality rate in the USA is approximately 3 %. The majority of bleeds (~75 %) arise from the upper gastrointestinal tract, defined as proximal to the ligament of Treitz. GIH is most common in the elderly, and this population is prone to having a higher incidence of associated medical comorbidities. In the GIH patient population, 80 % of the mortality is attributable to their associated comorbidities rather than as a direct consequence of their GI hemorrhage. As the elderly population of America continues to expand, it can be expected that the incidence of GI hemorrhage patients will also increase in a proportionate fashion.
References
Longstreth G. Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol. 1995;90:206–10.
Fllah M, Prakash C, Edmundowicz S. Acute gastrointestinal bleeding. Med Clin North Am. 2000;84:1183–208.
Delvaux M, Fassler I, Gray G. Clinical usefulness of the endoscopic video-capsule as the initial intestinal investigation in patients with obscure digestive bleeding validation of a diagnostic strategy based on the patient outcome after 12 months. Endoscopy. 2004;36:1067–73.
Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Phys. 2007;76(7):1005–12.
Warren JR, Marshall B. Unidentified curved bacilli on gastric epithelium in active gastritis. Lancet. 1983;1:1273.
Mercer DW, Robinson EK. Chapter 47. Peptic ulcer disease. In: Townsend CM et al., editors. Sabiston textbook of surgery. 18th ed. Philadelphia: Elsevier Saunders; 2008.
Harbison S, Dempsey D. Pepteic ulcer disease. Curr Prob Surg. 2005;42:346–454.
Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment and prognosis. World J Surg. 2000;24(3):277–83.
Schuster KM, Fever WJ, Barquist ES. Outcomes of cocaine-induced gastric perforations repaired with an omental patch. J Gastrointest Surg. 2007;11(11):1560–3.
Vakil N, Van Zanten SV, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20.
Zimmerman J, Shohat V, Tsvang E, et al. Esophagitis is a major cause of upper gastrointestinal hemorrhage in the elderly. Scand J Gastroenterol. 1997;32:906–9.
Lin PC, Change CH, Hsu PL, et al. The efficacy and safety of proton pump inhibitors vs. histamine-2 receptor antagonists for stress ulcer bleeding prophylaxis among critical care patients: a meta-analysis. Crit Care Med. 2010;38:1197–205.
Stollman N, Metz DC. Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. J Crit Care. 2005;20:35–45.
Cook DJ, Fuller HD, Fuyatt GH, et al. Risk factors for gastrointestinal bleeding in critically ill patients. N Engl J Med. 1994;330:377–81.
Cook DJ, et al. Risk factors for clinically important upper gastrointestinal bleeding in patients requiring mechanical ventilation. Canadian Critical Care Trials Group. Crit Care Med. 1999;27:2812–7.
Reilly J, Fennerty MB. Stress ulcer prophylaxis: the prevention of gastrointestinal bleeding and the development of nosocomial infections in critically ill patients. J Pharm Pract. 1998;11:418–32.
Laine L, Takevchi K, Tamawaski A. Gastric mucosal defence and cytoprotection: bench to bedside. Gastroenterology. 2008;135:41–60.
Alhazzani W, Alanezi F, Jaeschke RZ, et al. Proton pump inhibitor versus Histamine 2 receptor antagonists for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis. Crit Care Med. 2013;41(3):693–705.
Fennerty MB. Pathophysiology of the upper gastrointestinal tract in the critically ill patient: rationale for the therapeutic benefits of acid suppression. Crit Care Med. 2002;30(6 Suppl):S351–5.
DelValle J. Zollinger-Ellison syndrome and other neuroendocrine tumors. In: Wolfe MM, editor. Therapy of digestive disorders. New York: Elsevier; 2006. p. 469–84.
Dolan JP, Norton JA. Chapter 58. Zollinger-Ellison syndrome. In: Yeo CL, editor. Schakelford’s surgery of the alimentary tract. 6th ed. Philadelphia: Elsevier Saunders; 2007.
Hui AJ, Sung JJ. Endoscopic treatment of upper gastrointestinal bleeding. Curr Treat Options Gastroenterol. 2005;8:153–62.
Bharucha AE, Gostout CJ, et al. Clinical and endoscopic risk factors in the Mallory-Weiss syndrome. Am J Gastroenterol. 1997;92:805–8.
Cappell MS, Dass K, Manickam P. Characterization of the syndrome of UGI bleeding from a Mallory-Weiss tear associated with transesophageal echocardiography. Dig Dis Sci. 2014;59:2381–9.
Burks JA, Faries PL, et al. Endovascular repair of bleeding aortoenteric fistulas: a 5 year experience. J Vasc Surg. 2001;34:1055–9.
Samotowka M. Bariatric surgery complications for the acute care surgeon. Bariatric Surg. 2016; In Press.
Keyur P, Ali MA, Wong RCK. Unusual causes of upper gastrointestinal bleeding. Gastroenterol Endoscop Clin N Am. 2015;25(3):583–605.
Barkun A, Bardou M, Marshall JK, Nonvariceal Upper GI Bleeding Consensus Conference Group, et al. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843–57.
Barkun AN, Bardov M, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2010;152:101–13.
Reverter E, et al. A MELD-based model to determine risk of mortality among patients with acute variceal bleeding. Gastroenterol. 2014;146:412–9.
Garcia–Pagán JC, Patch D. Trials and tribulations: the prevention of variceal rebleeding. Gastroenterology. 2015;149(3):528–31.
Young PP, Cotton BA, Goodnough LT. Massive transfusion protocol for patients with substantial hemorrhage. Transfus Med Rev. 2011;25(4):293–303.
Bernard B, Grange JD, et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology. 1999;29:165–1661.
Chavez-Tapia N, et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010; 9:CD002907.
Burrough A, McCormick P, et al. Randomized, double-blind, placebo-controlled trial of somatostatic for variceal bleeding: emergency control and prevention of early variceal re-bleeding. Gastroenterol. 1990;99:1388–95.
Carbonell N, Pauwels A, et al. Improved survival after variceal bleeding patients with cirrhosis over the past two decades. Hepatology. 2004;40:652–9.
Garcia-Tsao G, Bosch J. Management of varicies and variceal hemorrhage in cirrhosis. N Engl J Med. 2010;362:823–32.
Garcia-Pagan J, Pascoli M, et al. Use of early TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study. J Hepatol. 2013;58:45–50.
Franchis R, on behalf of the Baveno VI faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63(3):743–52.
Gralnek IM. Obscure-overt gastrointestinal bleeding. Gastroenterol. 2005;128:1424–30.
Chen X, Zhi-Hua R, et al. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases. World J Gastroenterol. 2007;13(32):4372–8.
Triester SL, Leighton JA, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2005;100:2407–18.
Manner H. Argon plasma coagulation therapy. Curr Opin Gastroenterol. 2008;24(5):612–6.
Farrell JJ, Friedman LS. Gastrointestinal bleeding in the elderly. Gastroenterol Clin North Am. 2001;30:377–407.
Zuckerman GR, Prakash C. Acute lower intestinal bleeding: part 1: clinical presentation and diagnosis. Gastrointest Endosc. 1998;48(6):606–17.
Jacovides CL, Nadolski G, et al. Arteriography for lower gastrointestinal hemorrhage role of preceding abdominal computed tomographic angiogram in diagnosis and localization. JAMA Surg. 2015;150(7):650–6.
Nguyen NQ, Rayner CK, et al. Push enteroscopy alters management in a majority of patients with obscure gastrointestinal bleeding. J Gastroenterol Hepatol. 2005;20(5):716–21.
Farrell JJ, Friedman LS. Review article: the management of lower gastrointestinal bleeding. Aliment Pharmacol Ther. 2005;21:1281–98.
Tan KK, Nallathamby V, Wong D, Sim R. Can superselective embolization be definitive for colonic diverticular hemorrhage? An institutions experience over 9 years. J Gastrointest Surg. 2010;14(1):112–8.
Oldenburg WA, Lau LL, et al. Acute mesenteric ischemia: a clinical review. Arch Intern Med. 2004;164(10):1054–62.
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Samotowka, M.A. (2016). Gastrointestinal Hemorrhage. In: Martin, N.D., Kaplan, L.J. (eds) Principles of Adult Surgical Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-33341-0_16
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