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Urgent Workup for Upper Gastrointestinal Bleeding

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Gastrointestinal Bleeding

Abstract

Each year hundreds of thousands of patients suffer from acute upper gastrointestinal bleeding (UGIB) [1], which by definition arises from a site proximal to the ligament of Treitz. Etiological factors include peptic ulcer disease, gastritis, gastroesophageal varices, and Mallory–Weiss tears. Less common causes are marginal ulcers, esophagitis, gastric cancer, aorto-enteric fistulas, hemobilia, AV malformations (Fig. 1), and Dieulafoy lesions [2,3]. Peptic ulcer disease, including gastric/duodenal ulcers (Fig. 2) and erosive esophagitis/gastritis (Fig. 3), is the source of bleed 50–75% of the time [1,2,4,5]. The incidence of esophageal varices is 10–30%, Mallory–Weiss tears 4–13%, AVMs 2–4%, malignancies 1–5%, and Dieulafoy lesions 1–2% [5].

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References

  1. Laine L and Peterson WL. Bleeding peptic ulcer. N Engl J Med 1994;331:717–727.

    Article  PubMed  CAS  Google Scholar 

  2. Manning-Dimmitt L, Dimmit SG and Wilson GR. Diagnosis of gastrointestinal bleeding in adults. Am Fam Physician 2005;7:1339–1346.

    Google Scholar 

  3. Lefkovitz Z, Cappell MS, Kaplan M, et al. Radiology in the diagnosis and therapy of gastrointestinal bleeding. Gastroenterol Clin 2000;29:2.

    Google Scholar 

  4. Barkun A, Bardou M, Marshall JK, et al. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 2003;139:843–857.

    PubMed  Google Scholar 

  5. Burke SJ, Golzarian J, Weldon D, et al. Nonvariceal upper gastrointestinal bleeding. Eur Radiol 2007;17:1714–1726.

    Article  PubMed  Google Scholar 

  6. Longstreth GF. Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population based study. Am J Gastroenterol 1995;90:206–210.

    PubMed  CAS  Google Scholar 

  7. Rockall TA, Logan RF, Devlin HB, et al. Incidence of and mortality from acute upper gastrointestinal hemorrhage in the United Kingdom. Screening Committee and Members of the National Audit of Acute Upper Gastrointestinal Hemorrhage. BMJ 1995;311:222–226.

    PubMed  CAS  Google Scholar 

  8. Enestvedt BK, Gralnek I, Mattek N, et al. An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium. Gastrointest Endosc 2008;67(3):422 – 429.

    Article  PubMed  Google Scholar 

  9. Kasem AM, Kamal T, Chandra NN, et al. Management of acute upper gastrointestinal bleeding in a district hospital. J Laparoendosc Adv Surg Tech 2006;16:355–361.

    Article  Google Scholar 

  10. Rockall TA, Logan RF, Devlin HB, et al. Risk assessment after acute upper gastrointestinal hemorrhage. Gut 1997;38:316–321.

    Article  Google Scholar 

  11. Cappell MS and Friedel D. Acute nonvariceal upper gastrointestinal bleeding: endoscopic diagnosis and therapy. Med Clin NA 2008;92:511–550.

    Article  Google Scholar 

  12. Eisen GM, Dominitz JA, Faigel DO, et al. An annotated algorithmic approach to upper gastrointestinal bleeding. Gastrointest Endosc 2001;53(7):853–858.

    PubMed  CAS  Google Scholar 

  13. Tammaro L, Palol M, Zullo A, et al. Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy. World J Gastroenterol 2008;14:5046–5050.

    Article  PubMed  Google Scholar 

  14. Bjorkman D, Zaman A, Fennerty B, et al. Urgent vs. elective endoscopy for acute non-variceal upper-GI bleeding: an effectiveness study. Gastrointest Endosc 2004;60(1):1–7.

    Article  PubMed  Google Scholar 

  15. Tai C, Huang S, Wang H, et al. High-risk ED patients with nonvariceal upper gastrointestinal hemorrhage undergoing emergency or urgent endoscopy: a retrospective analysis. Am J Emerg Med 2007;25:273–278.

    Article  PubMed  Google Scholar 

  16. Forrest JA, Finalyson N and Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet 1974;ii:394–397.

    Article  Google Scholar 

  17. Miller M and Smith TP. Angiographic diagnosis and endovascular management of nonvariceal gastrointestinal hemorrhage. Gastroenterol Clin NA 2005;34:735–752.

    Article  Google Scholar 

  18. Concha R, Amaro R, Barkin J, et al. Obscure gastrointestinal bleeding: diagnostic and therapeutic approach. J Clin Gastroenterol 2007;413:242–251.

    Article  Google Scholar 

  19. Ettorre GC, Francioso G, Garribba AP, et al. Helical CT angiography in gastrointestinal bleeding of obscure origin. Am J Roentgenol 1997;168:727–731.

    CAS  Google Scholar 

  20. McKusick KA and Froelich J, Callahan RJ et al. 99mTc red blood cells for detection of gastrointestinal bleeding: experience with 80 patients. Am J Radiol 1981;137:1113–1118.

    CAS  Google Scholar 

  21. Martins NB and Wassef W. Upper gastrointestinal bleeding. Curr Opin Gastroenterol 2006;22:612–619.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Duke University Medical Center, Durham, NC, USA

    Loretta Erhunmwunsee M.D. & Sandhya A. Lagoo-Deenadayalan

Authors
  1. Loretta Erhunmwunsee M.D.
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  2. Sandhya A. Lagoo-Deenadayalan
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Correspondence to Sandhya A. Lagoo-Deenadayalan .

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Editors and Affiliations

  1. Medical Center, Duke University, N. Duke St 3116, Durham , 27704, U.S.A.

    Aurora D. Pryor

  2. Medical Center, Duke University, N. Duke St 3116, Durham , 27704, U.S.A.

    Theodore N. Pappas

  3. Medical Center, Duke University, Durham, 27710, U.S.A.

    Malcolm Stanley Branch

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Erhunmwunsee, L., Lagoo-Deenadayalan, S.A. (2010). Urgent Workup for Upper Gastrointestinal Bleeding. In: Pryor, A., Pappas, T., Branch, M. (eds) Gastrointestinal Bleeding. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1693-8_2

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  • DOI: https://doi.org/10.1007/978-1-4419-1693-8_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1692-1

  • Online ISBN: 978-1-4419-1693-8

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