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Urgent Workup for Upper Gastrointestinal Bleeding

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Gastrointestinal Bleeding

Abstract

Acute upper gastrointestinal bleeding afflicts thousands of patients each year, and can range from a mere nuisance to a life threatening condition. The underlying cause is most often peptic ulcer disease, gastritis, or varices. Infrequent causes include esophagitis, cancer, aorto-enteric fistulae, hemobilia, and arteriovenous malformations. This chapter elaborates on the rapid assessment and risk stratification of patients presenting with acute upper gastrointestinal bleeding. We discuss how endoscopy and other modalities aid in the localization and treatment of the bleeding source.

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References

  1. Rotondano G. Epidemiology and diagnosis of acute nonvariceal upper gastrointestinal bleeding. Gastroenterol Clin North Am. 2014;43:643–63.

    Article  PubMed  Google Scholar 

  2. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318–21.

    Article  CAS  PubMed  Google Scholar 

  3. Rockall TA, Logan RF, Devlin HB, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38(3):316–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. National Institute for Health and Clinical Excellence (NICE). Acute upper gastrointestinal bleeding: management. London, UK: NICE; 2012. p. 23 (Clinical guideline; no. 141).

    Google Scholar 

  5. Aljebreen AM, Fallone CA, Barkun AN. Nasogastric aspirate predicts high-risk endoscopic lesions in patients with acute upper-GI bleeding. Gastrointest Endosc. 2004;59(2):172–8.

    Article  PubMed  Google Scholar 

  6. Lin HJ, Wang K, Perng CL, et al. Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study. J Clin Gastroenterol. 1996;22(4):267–71.

    Article  CAS  PubMed  Google Scholar 

  7. Lee SD, Kearney DJ. A randomized controlled trial of gastric lavage prior to endoscopy for acute upper gastrointestinal bleeding. J Clin Gastroenterol. 2004;38(10):861–5.

    Article  PubMed  Google Scholar 

  8. Lee EW, Laberge JM. Differential diagnosis of gastrointestinal bleeding. Tech Vasc Interv Radiol. 2004;7(3):112–22.

    Article  PubMed  Google Scholar 

  9. Eisen GM, Dominitz JA, Faigel DO, et al. An annotated algorithmic approach to upper gastrointestinal bleeding. Gastrointest Endosc. 2001;53(7):853–8.

    Article  CAS  PubMed  Google Scholar 

  10. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107:345–60.

    Article  CAS  PubMed  Google Scholar 

  11. Hwang JH, Fisher DA, Ben-Menachem T, et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc. 2012;75(6):1132–8.

    Article  PubMed  Google Scholar 

  12. Spiegel BM, Vakil NB, Ofman JJ. Endoscopy for acute nonvariceal upper gastrointestinal tract hemorrhage: is sooner better? A systematic review. Arch Intern Med. 2001;161(11):1393–404.

    Article  CAS  PubMed  Google Scholar 

  13. Tsoi KK, Ma TK, Sung JJ. Endoscopy for upper gastrointestinal bleeding: how urgent is it? Nat Rev Gastroenterol Hepatol. 2009;6(8):463–9.

    Article  PubMed  Google Scholar 

  14. Lau JY, Sung JJ, Lam YH, et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med. 1999;340(10):751–6.

    Article  CAS  PubMed  Google Scholar 

  15. Cappell MS, Friedel D. Acute nonvariceal upper gastrointestinal bleeding: endoscopic diagnosis and therapy. Med Clin North Am. 2008;92:511–50.

    Article  PubMed  Google Scholar 

  16. Forrest JA, Finalyson N, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974;ii:394–7.

    Article  Google Scholar 

  17. Laine L, Peterson WL. Bleeding peptic ulcer. N Engl J Med. 1994;331:717–27.

    Article  CAS  PubMed  Google Scholar 

  18. 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):1–8.

    Article  PubMed  Google Scholar 

  19. Lefkovitz Z, Cappell MS, Kaplan M, et al. Radiology in the diagnosis and therapy of gastrointestinal bleeding. Gastroenterol Clin North Am. 2000;29(2):489–512.

    Article  CAS  PubMed  Google Scholar 

  20. Miller M, Smith TP. Angiographic diagnosis and endovascular management of nonvariceal gastrointestinal hemorrhage. Gastroenterol Clin North Am. 2005;34(4):735–52.

    Article  PubMed  Google Scholar 

  21. Concha R, Amaro R, Barkin J, et al. Obscure gastrointestinal bleeding: diagnostic and therapeutic approach. J Clin Gastroenterol. 2007;413:242–51.

    Article  Google Scholar 

  22. Burke SJ, Golzarian J, Weldon D, et al. Nonvariceal upper gastrointestinal bleeding. Eur Radiol. 2007;17:1714–26.

    Article  PubMed  Google Scholar 

  23. McKusick KA, Froelich J, Callahan RJ, et al. 99mTc red blood cells for detection of gastrointestinal bleeding: experience with 80 patients. Am J Roentgenol. 1981;137:1113–8.

    Article  CAS  Google Scholar 

  24. Manning-Dimmitt L, Dimmit SG, Wilson GR. Diagnosis of gastrointestinal bleeding in adults. Am Fam Physician. 2005;7:1339–46.

    Google Scholar 

  25. Ettorre GC, Francioso G, Garribba AP, et al. Helical CT angiography in gastrointestinal bleeding of obscure origin. Am J Roentgenol. 1997;168:727–31.

    Article  CAS  Google Scholar 

  26. Jaskolka JD, Binkhamis S, Prabhudesai V, et al. Acute gastrointestinal hemorrhage: radiologic diagnosis and management. Can Assoc Radiol J. 2013;64(2):90–100.

    Article  PubMed  Google Scholar 

  27. Wu LM, Xu JR, Yin Y, Qu XH. Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis. World J Gastroenterol. 2010;16(31):3957–63.

    Article  PubMed  PubMed Central  Google Scholar 

  28. García-Blázquez V, Vicente-Bártulos A, Olavarria-Delgado A, Plana MN, van der Winden D, Zamora J, et al. Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis. Eur Radiol. 2013;23(5):1181–90.

    Article  PubMed  Google Scholar 

  29. Wang Z, Chen JQ, Liu JL, Qin XG, Huang Y. CT enterography in obscure gastrointestinal bleeding: a systematic review and meta-analysis. J Med Imaging Radiat Oncol. 2013;57(3):263–73.

    Article  PubMed  Google Scholar 

  30. Chan V, Tse D, Dixon S, et al. Outcome following a negative CT Angiogram for gastrointestinal hemorrhage. Cardiovasc Intervent Radiol. 2015;38(2):329–35.

    Article  PubMed  Google Scholar 

  31. Martins NB, Wassef W. Upper gastrointestinal bleeding. Curr Opin Gastroenterol. 2006;22:612–9.

    PubMed  Google Scholar 

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Acknowledgements

Loretta Erhunmwunsee M.D. is credited with writing the core of this chapter in the first edition.

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Correspondence to Sandhya A. Lagoo-Deenadayalan .

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Mallipeddi, M.K., Lagoo-Deenadayalan, S.A. (2016). Urgent Workup for Upper Gastrointestinal Bleeding. In: Pryor, A., Pappas, T., Branch, M. (eds) Gastrointestinal Bleeding. Springer, Cham. https://doi.org/10.1007/978-3-319-40646-6_2

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  • DOI: https://doi.org/10.1007/978-3-319-40646-6_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40644-2

  • Online ISBN: 978-3-319-40646-6

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