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Gastrointestinal Hemorrhage

  • Harvey M. Licht
  • Fredric Jaffe
  • Gilbert E. D’Alonzo
Chapter

Abstract

After studying this chapter, you should be able to: Discuss the differential diagnosis of acute gastrointestinal bleeding. Describe the diagnostic and therapeutic maneuvers necessary to identify the cause and control of gastrointestinal hemorrhage in the ICU. Understand the role of endoscopy, surgery, and tube placement in upper and lower GI bleeding. Appreciate the complications of stress ulceration and how it occurs in the critically ill patient.

Keywords

Portal Hypertension Gastrointestinal Bleeding Hepatic Encephalopathy Cirrhotic Patient Esophageal Varix 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Schaffer J. Acute gastrointestinal bleeding. Med Clin N Am. 1986;70:1055-1060.Google Scholar
  2. 2.
    Rankin R. Acute upper gastrointestinal bleeding: therapy and prophylaxis. Prog Crit Care Med. 1985;2:167-174.Google Scholar
  3. 3.
    Gottlieb J, Menasha P, Cruz E. Gastrointestinal complications in critically ill patients: the intensivist’s overview. Am J Gastroenterol. 1986;81:227-238.PubMedGoogle Scholar
  4. 4.
    Barkun A, Sabbah S, Enns R, et al. The Canadian registry of nonvariceal upper gastrointestinal bleeding and endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting. Am J Gastroenterol. 2004;99:1238-1246.PubMedCrossRefGoogle Scholar
  5. 5.
    Chan F, Ching J, Hung L, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med. 2005;352:238-244.PubMedCrossRefGoogle Scholar
  6. 6.
    Barkun A, Bardou M, Marshall J. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843-857.PubMedGoogle Scholar
  7. 7.
    Grace N. Diagnosis and treatment of gastrointestinal bleeding secondary to portal hypertension. Am J Gastroenterol. 1997;92:1081-1091.PubMedGoogle Scholar
  8. 8.
    Rkall T, Logan R, Devlin H, Northfield T. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38:316-321.CrossRefGoogle Scholar
  9. 9.
    Beckman J, Tedesco F. Acute lower GI bleeding: the differential diagnosis. J Crit Illness. 1986;1:56-64.Google Scholar
  10. 10.
    Beckman J, Tedesco F. Acute management of lower GI bleeding. J Crit Illness. 1986;1:14-20.Google Scholar
  11. 11.
    Gostout C, Wang K, Alquist D. Acute gastrointestinal bleeding: experience of a specialized management team. J Clin Gastroen­terol. 1992;14:260-267.PubMedCrossRefGoogle Scholar
  12. 12.
    Rockall T, Logan R, Devlin H, Northfield T. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. BMJ. 1995;311:222-226.PubMedCrossRefGoogle Scholar
  13. 13.
    NIH Consensus Conference. Therapeutic endoscopy and bleeding ulcers. JAMA. 1989;262:1369-1372.CrossRefGoogle Scholar
  14. 14.
    Lau J, Leung W, Wu J, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med. 2007;356:1631-1640.PubMedCrossRefGoogle Scholar
  15. 15.
    Andriulli A, Loperfido S, Focareta R, et al. Bolus versus continuous high-dose omeprazole infusion combined with endoscopic hemostasis in peptic ulcer bleeding. A randomized, multicenter, Italian study. Gastrointest Endosc. 2007;65:AB120.CrossRefGoogle Scholar
  16. 16.
    Garcia-Tsao G, Sanyal A, Grace N, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922-938.PubMedCrossRefGoogle Scholar

Additional Reading

  1. Adler D, Leighton J, Davila R, et al. ASGE guideline: the role of endoscopy in acute non-variceal upper-GI hemorrhage. Gastrointest Endosc. 2004;60:497-504. (Erratum, Gastrointest Endosc. 2005;61:356).Google Scholar
  2. Barkun A, Sabbah S, Enns R, et al. The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting. Am J Gastroenterolog. 2004;99:1238-1246.CrossRefGoogle Scholar
  3. Barkun A, Bardou M, Marshall JK. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843-857.PubMedGoogle Scholar
  4. Garcia-Tsao G, Sanyal AJ, Grace ND, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922-938.PubMedCrossRefGoogle Scholar
  5. Gralnek I, Barkun A, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med. 2008;359:928-937.PubMedCrossRefGoogle Scholar
  6. Leontiadis G, Sharma V, Howden C. Proton pump inhibitor treatment for acute peptic ulcer bleeding. Cochrane Database Syst Rev. 2006;1:CD002094.PubMedGoogle Scholar
  7. Rockall T, Logan R, Devlin H, Northfield T. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38:316-321.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Harvey M. Licht
    • 1
  • Fredric Jaffe
    • 2
  • Gilbert E. D’Alonzo
    • 3
  1. 1.Department of MedicineTemple University School of MedicinePhiladelphiaUSA
  2. 2.Department of Medicine, Division of Pulmonary and Critical CareTemple University HospitalPhiladelphiaUSA
  3. 3.Pulmonary and Critical Care MedicineTemple University School of MedicinePhiladelphiaUSA

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