Diagnosis and Management of Upper Gastrointestinal Bleeding

Biecker, Erwin; Heller, J. Christie; Schmitz, Volker; Lammert, Frank; Sauerbruch, Tilman

doi:10.3238/arztebl.2008.0085

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…Die Inzidenz der oberen GI-Blutung beträgt etwa 50 auf 100.000 Personen pro Jahr mit einer Letalität zwischen 5 und 11% [2,5]. Die Ulkusblutung ist mit 35% die häufigste Ursache der oberen GI-Blutung; hierbei entfallen etwa 60% auf Duodenal-und 40% auf Magenulzera.…”

Section: Diskussionunclassified

Gastrointestinale Blutung nach Anlage einer biliodigestiven Anastomose

Bert

Rossol

2015

Gastroenterologe

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Section: Diskussionunclassified

Gastrointestinale Blutung nach Anlage einer biliodigestiven Anastomose

Bert

Rossol

2015

Gastroenterologe

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“…An upper gastrointestinal (GI) hemorrhage is described as blood loss from proximal GI tract (3). Patients with upper GI hemorrhage usually present with hematemesis (vomiting of blood and/or coffee-ground-like material) and/or melena (black, tarry stools), although hematochezia may be seen in a case of major bleeding and is typically associated with hemodynamic instability even hemorrhagic shock (4). The most frequent causes of upper gastrointestinal bleeding are peptic ulcer disease due to use of aspirin and/or other non-steroidal anti inflammatory drugs (NSAIDs), variceal bleeding, malignancies including gastric cancer and Mallory Weiss tears (5).…”

Section: Introductionmentioning

confidence: 99%

An unusual upper GI bleeding: Angiodysplasia at the hepaticojejunostomy anostomosis

EREN¹,

ÖCAL²,

DUMAN³

2022

JECM

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Upper gastrointestinal bleeding (UGIB) is a common condition causing a considerable number of admissions in clinics. The most frequent causes of UGIB are peptic ulcer disease, malignancies, variceal bleeding and Mallory Weiss tears. A 47-year-old male subject was admitted to the emergency service with recurrent episodes of melena. He had been hospitalized several times before, but he was discharged because the endoscopic procedures did not reveal any origin. There has been a history of Whipple surgery for pancreatic adenocarcinoma. When admitted he was tachycardic, melanic stool was noted on rectal examination and his hemoglobin level was decreased. Widespread angioectasia was detected at the borders of the biliary-enteric anastomosis, which was known to have bleeding on upper GI endoscopy. Despite their rare presentation, bleeding from the vascular ectasia near the anostomotic line should be kept in mind in the differential diagnosis of patients with gastrointestinal hemorrhage.

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“…The initial laboratory tests include a blood count, international normalized ratio, partial thromboplastin time, electrolytes, creatinine, and blood typing in case transfusion is necessary [5].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of non-variceal upper gastrointestinal bleeding and its relation to aspirin and anticoagulants.

Radwan¹,

Elsayed²,

Al-Shabrawi³

2020

Open Access Maced J Med Sci

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BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) is a life-threatening emergency that requires an urgent management. Antiplatelet (e.g., aspirin) and anticoagulant drugs are widely chronically used in various cardiac and coronary artery diseases. These drugs increase the risk of NVUGIB as they may cause ulceration of the upper gastrointestinal (GI) mucosa directly or may cause bleeding or rebleeding. The management of NVUGIB is complicated as the risk between GI bleeding episodes and cardiovascular attacks needs to be well managed. AIM: The aim of this study is to determine the impact of antiplatelets (aspirin) and anticoagulants use on the morbidity, mortality, and clinical outcomes in patients presented with non-variceal GI bleeding. PATIENTS AND METHODS: A total of 105 patients presented with melena and/or hematemesis and diagnosed by upper GI endoscopy were enrolled in a prospective cohort study. Patients were sub-grouped according to their use of antiplatelets, anticoagulants, or none (controls). Patients were excluded if they had portal hypertension or nonsteroidal anti-inflammatory drugs (NSAIDs) use and divided into five groups: Group I – patients who had not taken anticoagulants and antiplatelet; Group II – patients on heparin, warfarin, and LMWH only; Group III – patients on aspirin only; Group IV – patients on clopidogrel and ticlopidine with or without aspirin; and Group V – patients on combined anticoagulants and antiplatelet. All patients were subjected to clinical, laboratory (complete blood count, liver function tests, renal function tests, prothrombin time, and partial thromboplastin time), and endoscopic investigations. Clinical details were reported including admission, blood transfusion, rebleeding, and mortality. RESULTS: Full medical history revealed that 43 patients were diabetic, 45 patients were cardiac, and 67 patients were hypertensive. Regarding the history of analgesic drug intake, 38 patients used NSAIDs and 29 of them used non-selective NSAIDs and 8 patients used selective NSAIDs. There were non-significant differences among the studied groups with NVUGIB regarding sex, hematemesis only presentation, melena only presentation, liver function tests, and endoscopic findings. On the other hand, there were statistically significant differences between the studied groups with NVGIB regarding increasing age, NSAIDs use whatever selective or non-selective, decrease level of HB, WBCs, serum albumin, bleeding profile, kidney function tests, clinical presentation in the form of hematemesis and melena, need for blood transfusion, history of associated diseases, especially being cardiac patients, rebleeding after 6 and 12 months, and mortality. CONCLUSION: Aspirin intake may be associated with less favorable clinical outcomes in patients with NVUGIB, while combined anticoagulants and antiplatelets seem to be associated with the worse outcomes.

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Diagnosis and Management of Upper Gastrointestinal Bleeding

Abstract: Modern endoscopy affords good localization of the bleeding site and successful treatment for most patients with upper GI bleeding.

Cited by 9 publications

References 32 publications

Gastrointestinale Blutung nach Anlage einer biliodigestiven Anastomose

Gastrointestinale Blutung nach Anlage einer biliodigestiven Anastomose

An unusual upper GI bleeding: Angiodysplasia at the hepaticojejunostomy anostomosis

Clinical outcomes of non-variceal upper gastrointestinal bleeding and its relation to aspirin and anticoagulants.

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